{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:05:51Z","timestamp":1793383551671,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T00:00:00Z","timestamp":1437696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the incidence and risk factors of velopharyngeal insufficiency (VPI) postadenoidectomy, posttonsillectomy, and postadenotonsillectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic tertiary care center (2007\u20102014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Retrospective review of patients who underwent adenoidectomies, tonsillectomies, or adenotonsillectomies by 1 pediatric otolaryngologist. Patient\u2019s age, sex, type of surgery, indication for surgery, medical syndromes, tonsil grade, adenoid size, and pre\u2010 and postoperative nasal air emissions were obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The VPI risk at 3 weeks postoperatively was 13.6% (95% CI: 9.0%, 18.2%) for adenotonsillectomies, 3.2% (95% CI: 1.2%, 7.6%) for adenoidectomies, and 2.2% (95% CI: 2.1%, 6.5%) for tonsillectomies. There was a significantly higher risk of VPI with combined procedures in comparison with adenoidectomies (<jats:italic>P<\/jats:italic> =. 02) or tonsillectomies alone (<jats:italic>P<\/jats:italic> =. 03). There was no significant difference in risk of VPI between adenoidectomies and tonsillectomies (<jats:italic>P<\/jats:italic> =. 78); between surgical indication groups (sleep\u2010disordered breathing vs other; <jats:italic>P<\/jats:italic> =. 15); or in terms of sex (<jats:italic>P<\/jats:italic> =. 80), age (<jats:italic>P<\/jats:italic> =. 11), tonsil grade (<jats:italic>P<\/jats:italic> =. 96), or adenoid size (<jats:italic>P<\/jats:italic> =. 15). There was no qualitative difference in postoperative nasal air emissions between patients with and without medical syndromes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data are consistent with the literature that most VPI after adenotonsillectomy is temporary in nature and resolves by 5\u00a0months postoperatively. Combined procedures were shown to have a significantly higher risk of VPI. Our rates of VPI were much higher than that previously cited and may be indicative of subclinical cases of VPI, which were accounted for due to this study\u2019s unique methodology.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815596494","type":"journal-article","created":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T23:35:14Z","timestamp":1437780914000},"page":"1051-1055","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Incidence and Risk Factors of Velopharyngeal Insufficiency Postadenotonsillectomy"],"prefix":"10.1002","volume":"153","author":[{"given":"Maria","family":"Khami","sequence":"first","affiliation":[{"name":"Schulich School of Medicine &amp; Dentistry Western University London Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Tan","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine &amp; Dentistry Western University London Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Western University London Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan Thomas","family":"Glicksman","sequence":"additional","affiliation":[{"name":"Schulich School of Medicine &amp; 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