title: The functional role of the tonsils in speech.
abstract: OBJECTIVE
  To present illustrative cases showing various tonsillar influences on speech and to present a clinical method for patient evaluation establishing concepts of management and a rational therapeutic approach.
  
  
  METHODS
  The cases were selected from a group of approximately 1000 patients referred to the clinic because of suspected palatal diseases. Complete velopharyngeal assessment was made, including otolaryngologic, speech, and hearing examinations, polysomnography, nasendoscopy, multiview videofluoroscopy, and cephalometry.
  
  
  RESULTS
  New observations further elucidate the intimate relation between the tonsils and the velopharyngeal valve. The potential influence of the tonsils on the velopharyngeal valve mechanism, in hindering or assisting speech, is described.
  
  
  CONCLUSIONS
  In selected cases, the decision to perform tonsillectomy depends on its potential effect on speech. The combination of nasendoscopic and multiview videofluoroscopic studies of the mechanical properties of the tonsils during speech is required for patients who present with velopharyngeal insufficiency in whom tonsillar hypertrophy is found. These studies are also required in patients with palatal anomalies who are candidates for tonsillectomy.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Meir Hospital, Kfar Saba, Israel.
authors.forename: Y
authors.initials: Y
authors.lastname: Finkelstein
authors.forename: A
authors.initials: A
authors.lastname: Nachmani
authors.forename: D
authors.initials: D
authors.lastname: Ophir
mesh_terms: D002508:Cephalometry; D002933:Cineradiography; D002972:Cleft Palate / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D005471:Fluoroscopy; D006801:Humans; D006984:Hypertrophy; D009119:Muscle Contraction / Q000502:physiology; D010156:Palatal Muscles / Q000033:anatomy & histology / Q000502:physiology; D010160:Palate, Soft / Q000033:anatomy & histology / Q000502:physiology; D014066:Palatine Tonsil / Q000473:pathology / Q000502:physiology*; D010609:Pharyngeal Muscles / Q000033:anatomy & histology / Q000502:physiology; D010614:Pharynx / Q000033:anatomy & histology / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D013060:Speech / Q000502:physiology*; D013064:Speech Disorders / Q000503:physiopathology; D014068:Tonsillectomy; D014681:Velopharyngeal Insufficiency / Q000473:pathology / Q000503:physiopathology / Q000601:surgery