title: Should velopharyngoplasty and tonsillectomy in the cleft palate child be performed simultaneously?
abstract: OBJECTIVE
  This study was undertaken to answer the question of whether the simultaneous performance of velopharyngoplasty and tonsillectomy in the cleft palate child has an influence on the speech outcome or on the rate of operation-related complications.
  
  
  METHODS
  A series of 35 patients with simultaneous tonsillectomy and velopharyngoplasty was compared with 20 patients with these operations performed at different times. The evaluation of speech characteristics comprised defects of articulation (rhinolalia), voice quality (rhinophonia), the presence of nasal snorting, and the quality of spontaneous speech in four grades before operation and at final examination.
  
  
  RESULTS
  The comparison showed greater improvement of the speech parameters associated with velopharyngeal closure for the patients operated on simultaneously. No difference concerning the quality of spontaneous speech was seen. The rate of intraoperative and postoperative complications and morphologic disturbances did not differ between the groups.
  
  
  CONCLUSIONS
  The cleft palate child with velopharyngeal incompetence and enlarged tonsils seems to benefit from a simultaneous velopharyngoplasty and tonsillectomy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Knappschaftskrankenhaus, Bochum, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Eufinger
authors.forename: V
authors.initials: V
authors.lastname: Eggeling
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000601:surgery; D001184:Articulation Disorders / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010160:Palate, Soft / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications; D013060:Speech / Q000502:physiology; D013064:Speech Disorders / Q000517:prevention & control; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods; D013997:Time Factors; D014068:Tonsillectomy / Q000009:adverse effects; D014681:Velopharyngeal Insufficiency / Q000601:surgery; D014833:Voice Quality / Q000502:physiology