Should velopharyngoplasty and tonsillectomy in the cleft palate child be performed simultaneously?

PURPOSE

This study was undertaken to answer the question of whether the simultaneous performance of velopharyngoplasty and tonsillectomy in the cleft palate child has an influence on the speech outcome or on the rate of operation-related complications.

PATIENTS AND METHODS

A series of 35 patients with simultaneous tonsillectomy and velopharyngoplasty was compared with 20 patients with these operations performed at different times. The evaluation of speech characteristics comprised defects of articulation (rhinolalia), voice quality (rhinophonia), the presence of nasal snorting, and the quality of spontaneous speech in four grades before operation and at final examination.

RESULTS

The comparison showed greater improvement of the speech parameters associated with velopharyngeal closure for the patients operated on simultaneously. No difference concerning the quality of spontaneous speech was seen. The rate of intraoperative and postoperative complications and morphologic disturbances did not differ between the groups.

CONCLUSIONS

The cleft palate child with velopharyngeal incompetence and enlarged tonsils seems to benefit from a simultaneous velopharyngoplasty and tonsillectomy.