VELOPHARYNGEAL INSUFFICIENCY FOLLOWING PALATINE TONSILLECTOMY

Although adenotonsillectomy is usually considered a minor operation, n umerous uncommon but severe complications have been described. Even to nsillectomy alone can cause velopharyngeal insufficiency (VPI). We des cribe two cases in which severe VPI was noted after palatine tonsillec tomy was performed because of recurrent peritonsillar abscesses. The p atients underwent clinical examination, nasalance measurements, videon asopharyngoscopy and videofluoroscopy. Findings in both patients were consistent with lesions of branches of the vagus and glossopharyngeal nerves through lingual rami, while one of the patients probably also h ad a lesion of the hypoglossal nerve. Endoscopic and videofluoroscopic examinations demonstrated essential differences in the patients' preo perative state of velopharyngeal anatomy. Findings demonstrate the val ue of careful postoperative endoscopic and videofluoroscopic examinati on in cases with VPI after tonsillectomy to identify factors affecting subsequent VPI and to design possible treatment.