View Full Version : Learned something new about clefts

04-15-2009, 08:45 AM
In connection with some discussions about a cousin of Alex's, I learned something new about cleft palate repair and the role adenoids play in the repair. Since it was news to me, I thought I'd pass it along. Below is an excerpt of an email from Alex's LTP surgeon explaining it to me.

"i think i understand what the ent physician meant. the issue with the adenoids in a cleft palate patient is that if the adenoids are removed, the child is at greater risk of what is called velopharyngeal insufficiency (vpi). this means that when the child is speaking or swallowing; air (the voice) and food may escape through the nose. this happens because the adenoids provide bulk in the back of the nasopharynx. a cleft palate which has been repaired never functions as nicely as an intact palate. the role of the palate is to seal the nose when one speaks or swallows, therefore a child with a repaired palate frequently in many ways "depends" on the adenoids being there to seal the nose during swallow and speech. for this reason, in kids having sleep apnea in this setting, one frequently only removes the tonsils, and possibly just the superior half of the adenoids (not the lower half which aids the palate seal the nose)."

04-15-2009, 11:19 AM
Yes, our ENT did not remove the entire portion of Myles' adenoids. He left some behind to give structure to the palate for the same reason mentioned.

Gretchen(Celia's mom)
04-15-2009, 06:29 PM
Very interesting and good to know!!!