Adenoidectomy and persistent velopharyngeal insufficiency: Considerations, risk factors, and treatment

Lambert, Elton M.; You, Peng; Kacmarynski, Deborah S. F.; Rosenberg, Tara L.

doi:10.1016/j.ijporl.2021.110846

Cited by 6 publications

(2 citation statements)

References 52 publications

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“…Patients with cleft palate, bifid uvula, poor palatal motion, and deep pharynx have a higher risk of developing VPI and should undergo a partial superior adenoidectomy so as to decrease risk. Above 50% of patients with VPI will respond to speech therapy and, in the case of treatment failure, various surgical options are available [71].…”

Section: Adenoidectomy Complicationmentioning

confidence: 99%

Therapeutic Approaches in Chronic Adenoiditis

Giourgos¹,

Luchena²,

Bovi³

2023

Tonsils and Adenoids

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Adenoid tissue diseases (acute adenoiditis, adenoid hypertrophy and chronic adenoiditis) typically occur in the childhood. Adenoid hypertrophy seems to be related to many factors, such as infections, passive smoking, low vitamin D levels, while the role of allergy still remains controversial. Chronic adenoiditis incidence has increased in recent years, as a result of higher rates of upper airway infections and biofilm formation, with multiple potential clinical complications. Diagnosis is typically clinical, with physical examination and nasal endoscopy. The treatment can be medical or surgical. Non-surgical treatment of chronic adenoiditis with intranasal steroids and leukotriene inhibitors have proven to be effective, reducing the size of the adenoid tissue and symptoms. On the other hand adenoidectomy is one of the commonest ENT surgical procedures with excellent outcomes and rare adverse events. Curettage adenoidectomy is widely used by many ENT surgeon, but presents risk of residual adenoidal tissue, especially in peritubaric and superior nasopharynx regions. In the last years different surgical techniques have been proposed to reduce surgical risk and morbidity, such as electrocautery adenoidectomy, microdebrider adenoidectomy and coblation adenoidectomy. Intranasal or transoral endoscopes enabled a great control of surgical field and a complete removal of adenoid tissue.

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Section: Adenoidectomy Complicationmentioning

confidence: 99%

Therapeutic Approaches in Chronic Adenoiditis

Giourgos¹,

Luchena²,

Bovi³

2023

Tonsils and Adenoids

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“…Patients undergoing surgery in the Waldeyer's ring area typically present an increase in the cross-sectional area of the nasopharyngeal airway, which can normalize within a period of 3 to 6 months or permanently cause VPI, especially in patients with greater pharyngeal depth. Moreover, irregularities in adenoid tissue in the surgical bed can create channels through which air can inadvertently escape to the nose [39]. It is necessary to individualize each case, weighing the balance between benefit and risk in the indication of nasopharyngeal surgery in wind instrument players due to the professional consequences that may arise from it.…”

Section: Other Associated Factorsmentioning

confidence: 99%

Velopharyngeal Incompetence in Musicians: A State-of-the-Art Review

Mata-Pose,

Mayo-Yáñez,

Chiesa-Estomba

et al. 2023

JPM

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The velopalatine sphincter is a muscular valve that creates a hermetic seal between the nasopharynx and the oropharynx. It guarantees phonation, swallowing, and breathing (forces expirations). In wind musicians, sphincter closure must be precise during sound generation. Its failure will cause velopharyngeal incompetence (VPI) and the end of professional success. The objective of this article was to conduct a state-of-art review of VPI in wind musicians with a systematic approach based on the PRISMA Statement. The etiology, epidemiology, clinic, diagnosis, and treatment of VPI in wind musicians were evaluated. The research was carried out in different databases (PubMed/MEDLINE, the Cochrane Library, Scielo) and through the Mergullador metasearch engine. A total of 20 publications were selected. VPI is a pathology that affects around one-third of wind musicians according to studies. It causes pharyngeal noises and nasal air emissions during performance. The main etiology seems to be the fatigue of the velopalatine sphincter muscles. The most used diagnostic techniques consist of clinical history, physical examination, and nasofibroscopy. There is no consensus among authors about therapeutic management. Future investigations are necessary to confirm that fatigue of velopalatine sphincter muscles and other factors that increase it are the main causes of VPI in wind musicians.

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Indications des aérateurs transtympaniques

Blanc

Mondain

2023

Journal de Pédiatrie et de Puériculture

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Adenoidectomy and persistent velopharyngeal insufficiency: Considerations, risk factors, and treatment

Cited by 6 publications

References 52 publications

Therapeutic Approaches in Chronic Adenoiditis

Therapeutic Approaches in Chronic Adenoiditis

Velopharyngeal Incompetence in Musicians: A State-of-the-Art Review

Indications des aérateurs transtympaniques

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