Role of endoscopic guided partial adenoidectomy in avoiding open nasality

ObjectivesAssess the effects of endoscopic guided partial adenoidectomy on resonance of speech in patients with poor palatal mobility and evaluate its role in avoiding postoperative open nasality.Materials and methodsThis study was a prospective randomized trial conducted in one year duration. A total of 40 patients were assessed for eligibility; 24 patients were excluded as they did not meet the inclusion criteria. Two patients out of the eligible sixteen refused surgery. Inclusion criteria: 1-patient complaining of snoring, nasal obstruction and nasal discharge, all of which were caused by adenoid. 2-Poor palatal mobility on endoscopic examination. Exclusion criteria: any neurological deficit, muscular disorder or structural defects of the palate. All eligible patients had undergone partial adenoidectomy. Speech was evaluated preoperative and postoperative.ResultsThe study group had definite poor palatal mobility on endoscopic examination and lateral videofluroscopy. Endoscopic guided partial adenoidectomy has been done to all 14 patients. Postoperative evaluation showed marked relieving of symptoms such as nasal obstruction, discharge and mouth breathing with successfully maintaining the velopharyngeal competence but there was no complete relieving of closed nasality.ConclusionThere is necessity to screen potential candidates for adenoidectomy in order to prevent postoperative velopharyngeal dysfunction. Nasoendoscopy and lateral videofluroscopy have been useful to examine the palatal mobility, palatal length, depth of the pharynx and to exclude possible occult cleft palate. Partial adenoidectomy should be taken into consideration for risky patients. Satisfactory results were obtained as regards relieving nasal symptoms and maintaining velopharyngeal competence but didn’t improve quite fully the closed nasality