Objectives: Assess 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 methods: This 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.
Results: The 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.
Conclusion: There 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.