F Kassem1,2,3, Y Ebner1,2,3, B Nageris1,2,3, N Watted4, A DeRowe2,5, A Nachmani3,6. 1. Department of Otolaryngology-Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel. 2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Department of Otolaryngology-Head and Neck Surgery, The Center for Cleft Palate and Craniofacial Anomalies, Meir Medical Center, Kfar Saba, Israel. 4. Clinic and Policlinics for Dental, Oral and Maxillofacial Diseases of Bavarian Julius-Maximilian University Wuerzburg, University Hospital of Wuerzburg, Wuerzburg, Germany. 5. Pediatric Otolaryngology Unit, Department of Otolaryngology Head and Neck Surgery, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center. 6. Faculty of Communication Disorders, Hadassah Academic College, Jerusalem, Israel.
Abstract
OBJECTIVES: To characterise the craniofacial structure by cephalometry, especially the skull base and nasopharyngeal space, in children who underwent adenoidectomy and developed persistent velopharyngeal dysfunction (VPD). DESIGN: Retrospective study. SETTING: Speech and swallowing clinic of a single academic hospital. PARTICIPANTS: Thirty-nine children with persistent VPD following adenoidectomy (mean age 8.0±3.6 years) and a control group of 80 healthy children. MAIN OUTCOME MEASURES: Cephalometric landmarks were chosen; craniofacial linear and angular dimensions were measured and analysed. RESULTS: The linear dimensions of the nasopharyngeal area were shorter in the VPD group, S-Ba (41.6±4.2 mm, P<.05) and S-Ptm (42.4±5.1 mm, P<.05). The anterior skull base, N-S, was similar (68.1 mm±6.8). The velum length, Ptm-P was significantly shorter in the VPD group (27.8±4.3 mm, P<.001). The Ba-S-Ptm angle was significantly larger in the VPD group (63.5±5.6°, P<.001). There was no significant difference in cranial base angle (CBA), Ba-S-N, between the two groups. CONCLUSIONS: Cephalometry may provide information regarding persistent postoperative VPD. The nasopharyngeal space angle and velar length appear to be risk factors for persistent VPD after adenoidectomy.
OBJECTIVES: To characterise the craniofacial structure by cephalometry, especially the skull base and nasopharyngeal space, in children who underwent adenoidectomy and developed persistent velopharyngeal dysfunction (VPD). DESIGN: Retrospective study. SETTING: Speech and swallowing clinic of a single academic hospital. PARTICIPANTS: Thirty-nine children with persistent VPD following adenoidectomy (mean age 8.0±3.6 years) and a control group of 80 healthy children. MAIN OUTCOME MEASURES: Cephalometric landmarks were chosen; craniofacial linear and angular dimensions were measured and analysed. RESULTS: The linear dimensions of the nasopharyngeal area were shorter in the VPD group, S-Ba (41.6±4.2 mm, P<.05) and S-Ptm (42.4±5.1 mm, P<.05). The anterior skull base, N-S, was similar (68.1 mm±6.8). The velum length, Ptm-P was significantly shorter in the VPD group (27.8±4.3 mm, P<.001). The Ba-S-Ptm angle was significantly larger in the VPD group (63.5±5.6°, P<.001). There was no significant difference in cranial base angle (CBA), Ba-S-N, between the two groups. CONCLUSIONS: Cephalometry may provide information regarding persistent postoperative VPD. The nasopharyngeal space angle and velar length appear to be risk factors for persistent VPD after adenoidectomy.