Department of Otolaryngology, KasrAlainy Faculty of Medicine, Cairo University, 2 El-Salam St., King Faisal, Above El-Baraka Bank, Giza, Cairo, Egypt.
Department of Otolaryngology (Unit of Phoniatrics), KasrAlainy Faculty of Medicine, Cairo University, Cairo, Egypt.
Eur Arch Otorhinolaryngol. 2023 Oct;280(10):4555-4560. doi: 10.1007/s00405-023-08049-y. Epub 2023 Jun 10.
Adenoidectomy, either alone or with tonsillectomy, is a common surgical procedure in the field of pediatric otorhinolaryngology. Resonance function may be altered postoperatively in the form of hypernasality, which is usually transient. This study aimed to investigate the effect of adenoid size on post-adenoidectomy hypernasality in children with a normal palate.
Seventy-one children with different degrees of adenoid hypertrophy were included in this prospective observational study. Endoscopic assessment of the adenoid size and preoperative and postoperative evaluation of speech (at 1 and 3 months) with auditory perceptual assessment (APA) and nasometry were performed.
APA showed preoperative hyponasality in 59.1% of children and was found to be significantly related to the adenoid size, with more hyponasality in grades 3 and 4. One month postoperatively, hypernasality was detected in 26.7% of patients and was found to be related to the preoperative adenoid size with higher hypernasality in grades 3 and 4. Three months postoperatively, all patients had gained normal nasality except one (1.4%) who was subjected to a longer follow-up period. Nasometric assessment showed significant differences at the three visits (pre, 1, and 3 months postoperatively), with a negative correlation between the grade of adenoid size and nasalance scores preoperatively and a significant positive correlation between them at 1 month postoperatively. However, no significant correlation was detected at 3 months postoperatively.
Transient hypernasality may develop in some patients after adenoidectomy, especially in children with a larger preoperative adenoid size. However, transient hypernasality generally resolves spontaneously within 3 months.
腺样体切除术（单独施行或与扁桃体切除术联合施行）是小儿耳鼻喉科的常见手术。术后共鸣功能可能会发生改变，表现为鼻音过高等暂时现象。本研究旨在探讨正常腭的儿童腺样体大小对腺样体切除术后鼻音过高的影响。
本前瞻性观察研究纳入了 71 例不同程度腺样体肥大的儿童。对腺样体大小进行内镜评估，并在术前和术后 1 个月和 3 个月进行听觉感知评估（APA）和鼻音计评估以评估语音。
APA 显示术前有 59.1%的儿童存在低鼻音，且与腺样体大小显著相关，3 级和 4 级的低鼻音更明显。术后 1 个月，26.7%的患者检测到高鼻音，与术前的腺样体大小有关，3 级和 4 级的高鼻音更明显。术后 3 个月，除 1 例（1.4%）患者需要进行更长时间的随访外，所有患者均恢复正常鼻音。鼻音计评估显示在三次就诊时（术前、术后 1 个月和 3 个月）有显著差异，术前腺样体大小分级与鼻音值呈负相关，术后 1 个月呈显著正相关，但术后 3 个月无显著相关性。
腺样体切除术后，一些患者，特别是术前腺样体较大的儿童，可能会出现暂时的鼻音过高。然而，这种暂时的鼻音通常会在 3 个月内自然消退。
