Assessing palatal mobility in post-tonsillectomy patients

Objectives: To assess palatal mobility in post-tonsillectomy patients. Material and methods: This study was conducted in one year duration in Sohag University Hospital and consisted of 100 patients with ages ranging from 4 to 21years. Inclusion criteria: history with previous tonsillectomy at least since 6months or more. Exclusion criteria: any neurological deficit, muscular disorder or structural defects of the palate such as cleft palate or submucous cleft palate. All patients had undergone ear, nose and throat examination. Palatal mobility was assessed through oral examination. Further assessing palatal mobility by endoscopic examination and videofluoroscopy was done for those who have poor palatal mobility detected by intraoral examination. Result: Forty patients (23 males, 17 females) had poor palatal mobility on oral examination. Fourteen patients (8 males, 6 females) had definite poor palatal mobility on endoscopic examination. On Auditory Perceptual Assessment, 12 patients had closed nasality and 2 patients had mixed nasality. On endoscopic examination, 14 patients had a large adenoid. In 12 patients, the velopharyngeal orifice closure was veloadenoidal closure while in the other 2 patients there was slight velopharyngeal incompetence (coronal closure). Conclusion: Poor palatal mobility may be caused by malpractice of tonsillectomy or it may be a sign that was present and missed by the otolaryngologist. Pre-tonsillectomy evaluation of palatal mobility should be done by nasofiberoptic endoscope and/or videofluoroscopy. Also post-tonsillectomy evaluation of palatal mobility should be taken in consideration if adenoidectomy is needed to prevent possible postoperative open nasality