Palatal eversion for the treatment of combined nasopharyngeal stenosis and tonsillar pillars adhesion |
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| Institution: | 2. Department of Clinical Nutrition and Dietetics, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan;3. Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, The Hashemite University, Zarqa, Jordan;4. Department of Radiology, King Hussien Medical Center, Jordanian Royal Medical Services, Amman, Jordan;1. Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China;2. Department of Laboratory Medicine, Central Hospital of Zibo, Zibo, Shandong, China;1. Department of Comparative Biomedical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, United States;2. Department of Oral and Maxillofacial Surgery, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, United States;1. Department of Neurosurgery, NYU Medical Center, New York, New York, USA;2. Department of Neurosurgery, Lenox Hill Hospital, Zucker School of Medicine at Hofstra/Northwell Health, New York, New York, USA;3. Department of Neurosurgery, North-Shore Hospital, Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York, USA;4. Department of Radiology, North-Shore Hospital, Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York, USA;1. Ceará Federal University, Professor Costa Mendes St, 1608, Rodolfo Teófilo, Fortaleza, Ceara, Zip Code: 60430-140, Brazil;2. Patology Department, Ceará Federal University, Professor Costa Mendes St, 1608, Rodolfo Teófilo, Fortaleza, Ceara, Zip Code: 60430-140, Brazil;3. Farmacology Faculty, Ceará Federal University, Professor Costa Mendes St, 1608, Rodolfo Teófilo, Fortaleza, Ceara, Zip Code: 60430-140, Brazil;4. Otorhinolaryngology Department, Ceará Federal University, Professor Costa Mendes St, 1608, Rodolfo Teófilo, Fortaleza, Ceara, Zip Code: 60430-140, Brazil;1. Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;2. Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA |
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| Abstract: | ObjectiveRarely the tonsillar pillars and the soft palate became adherent to the posterior nasopharyngeal wall by strong fibrous tissue due to excessive dissection and cauterization during surgery leading to nasopharyngeal stenosis. Therefore, many treatment modalities are being tried to cure this problem. The aim of this study is to explore our results of modifying the basic technique to accommodate those patients with combined nasopharyngeal stenosis and tonsillar pillars adhesions in one stage. Study Design: Case series.MethodsThis study was conducted on 10 patients with combined nasopharyngeal stenosis and tonsillar pillars adhesions after adenotonsillectomy. They were subjected to treatment by palatal eversion through dividing the soft palate in the midline to separate each pillar from the pharyngeal wall in continuation with each half of soft palate and removal of the fibrous tissue causing stenosis. This was followed by eversion and fixation of the two palatal divisions on either side to allow complete epithelialization of the stenotic area. Postoperative follow-up was done for one year by the flexible nasopharyngoscopy, perceptual speech analysis, and polysomnography.ResultsThe flexible nasopharyngosopic examination of the 10 patients at the end of post-operative period revealed a freely mobile soft palate with no nasopharyngeal stenosis or palatal fistula. Velopharyngeal function and speech assessment by perceptual speech analysis was normal in all 10 cases. No obstructive episodes were recorded in polysomnograms.ConclusionsPalatal eversion is a promising technique in the treatment of post-adenotonsillectomy of combined nasopharyngeal stenosis and tonsillar pillars adhesion. It is recommended to be used on a wider scale of patients and other indications as nasopharyngeal stenosis following uvulopalatoplasty and post nasopharyngeal radiotherapy. The level of evidence: 4 (case series). |
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| Keywords: | Nasopharyngeal stenosis Palatal eversion Adenotonsillectomy complications |
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