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Hi.

Josh 4 1/2yrs old has always had a strong nasal sound that now seems

to hinder his speech. Have any of you had this problem with your

children? We had his adnoids checked, thinking that having them

removed might solve the problem, but the specialist didn't think it

was necessary. Any suggestions?

Rita

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We went through this for several years, and 3 ENTs, before finally

one suggested an easy endoscopy, which discovered an insufficiency

with her palate (what this means is that the palate moves back and

forth as the child speaks and makes closure with the back of the

throat). WHen this closure is not complete, air escapes into the

sinus area, hence the nasal speech.

If a child has nasal speech at under age 7 or 8, our ENT and plastic

surgeon both told us that the nasal speech will only get worse as

the child gets older. This is because adenoids are usually larger

when the child is younger, and as the child hits age 8 and older,

the adenoids shrink. As they shrink, if the reason the child had

hypernasal was because of insufficient palate, then the " gap "

becomes increasing larger, making the nasal speech more pronounced.

Our daughter went through intensive private speech therapy for 3

years, with no improvement in the hypernasality. The ENT explained

that when hypernasality is due to palate closure issues, therapy

would not improve it.

I would recommend asking an ENT for an endoscopy (child is awake,

they just put a smal tube down the nose and take pictures).

If your child does need surgery, PLEASE email me privately. Our

daughter had successful surgery (no more hypernasality) but had a

lot of complications post-surgerical.

Salem

> Hi.

> Josh 4 1/2yrs old has always had a strong nasal sound that now

seems

> to hinder his speech. Have any of you had this problem with your

> children? We had his adnoids checked, thinking that having them

> removed might solve the problem, but the specialist didn't think

it

> was necessary. Any suggestions?

> Rita

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Actually taking out the adenoids may make it worse if the nasality is due

to nasopharyngeal insufficiency. There is a surgery for this. We know a

neighbor whose son had this and when his adenoids were removed he spoke

like Daffy Duck and his food came through his nose, so he had to have a

plastic surgeon make artificial adenoids for him. Our son has had sleep

apnea and nasality, so we are trying to find the best balance. It seems

his tonsils are better this year in proportion to his throat when they are

swollen, but if he gets them out, we'll probably leave the adenoids in.

The adenoids go down anyway after childhood, and then we may need to

address the nasality even more...

Inga

At 04:40 PM 10/8/2003 +0000, you wrote:

>Hi.

>Josh 4 1/2yrs old has always had a strong nasal sound that now seems

>to hinder his speech. Have any of you had this problem with your

>children? We had his adnoids checked, thinking that having them

>removed might solve the problem, but the specialist didn't think it

>was necessary. Any suggestions?

>Rita

>

>

>

>

>

>

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also had sleep apnea problems. That is why our ENT (who works

with Dr H) took out part of 's adenoids and part of 's

tonsils.

Judith, Steve, (RSS) and (non RSS) 3 1/2 year old twins

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Our endo said that the partials grow back, although I wonder if the partial

would still give him enough growing time that growing back wouldn't matter

so much...

Did they have any troubles intubating your son for the surgery? That was a

big concern of mine since they had problems intubating him at birth

(couldn't) and at his g-tube surgery (did, but with much difficulty). I

thought that with the surgery going on in the throat area that it might be

riskier - thankfully, the surgeon here does have a great rep, though. He's

being conservative, maybe because we're concerned.

Inga

At 06:04 PM 10/10/2003 +0000, you wrote:

> also had sleep apnea problems. That is why our ENT (who works

>with Dr H) took out part of 's adenoids and part of 's

>tonsils.

>

>Judith, Steve, (RSS) and (non RSS) 3 1/2 year old twins

>

>

>

>

>

>

>

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They explained to us that his tonsils and adenoids were the size

they should be if didn't have RSS. BTW, it is even possible

for them to grow back if they are removed entirely. This happened

to me as a kid.

The idea was to give some time to grow and at least

temporarily help with the sleep apnea.

As for intubating , as far as we know there was no problem

either with this surgery or his gtube. Keep in mind, that we are

doing all of this at NYH with doctors who work with Dr H all the

time and are used to our kids so they know what to expect. We

didn't even need to remind them that needed to be the first

surgery in the am so he wouldn't be npo for too long.

Judith, Steve, (RSS) and (non RSS) 3 1/2 year old twins

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