The importance of endoscopic evaluation of adenotonsillar hypertrophy and its influence on nasal resonance and articulation in children

Adenotonsillar hypertrophy is very common in childhood. Obstruction of the nasopharyngeal airway may cause obligatory oral breathing, chronic open-mouth posture, incorrect inferior or anterior-inferior position of the tongue, disordered swallowing and impaired facial growth. Facial growth disorders frequently result in onset of the specific types of malocclusion and specific speech disorders. Obstruction of the pharynx during sleep by adenotonsillar hypertrophy remains the main cause of sleep apnea syndrome in children. Obstruction of the upper airway by the enlarged adenoid and/or hypertrophic tonsils may lead to hyponasality of the voice and/or cul-de-sac resonance. Malocclusions, in turn, in association with the incorrect tongue positioning in the oral cavity give rise to the disordered articulation of anterior consonants.