Adult tonsillectomy: anatomical differences affect postoperative transient hypernasality.

OBJECTIVE Our purpose was to determine how anatomical conditions of the throat influence the degree and duration of posttonsillectomy transient hypernasality. PATIENTS AND METHODS A total of 82 tonsillectomies were performed. The participants were divided into groups: 1 – small tonsils, high soft palate position; 4 – large tonsils, low soft palate position, and 2 and 3 – intermediate tonsil dimensions and soft palate positions. Variables studied included the diameter of vapor (DV) on the mirror positioned under the patient's nose while articulating nasal sentences before and after surgery, the distance from the uvular tip to the posterior pharyngeal wall, healing grading as well as the degree and duration of hypernasality. RESULTS The mean hypernasality after tonsillectomy was greatest in group 4 and lowest in group 2. Before tonsillectomy, the mean DV was largest in group 2 and smallest in group 4. After tonsillectomy, the mean DV was largest in group 4 and smallest in group 3. Overall, the mean DV was significantly greater after tonsillectomy compared to the value before surgery. CONCLUSION The degree of hypernasality after tonsillectomy depends on the soft palate position in relation to the tongue base and the size of the tonsils. Hypernasality is greatest in patients with large tonsils and a low soft palate position in relation to the tongue base.