Tonsillectomy-Adenoidectomy and Hypernasality
Posted by Heidi | Filed under Early Language Development, Improving Articulation
My sister-in-law called me today with questions about her son that recently had his tonsils and adenoids out. She was saying that since the surgery he received one week ago he suddenly has a very nasal quality about his speech.
Temporary change in voice following surgery is common.
In response to her concern I explained that it is common for children following a tonsil adenoidectomy to experience a temporary change in voice after the surgery for the first few months until the soft palate has lengthened enough to close the gap left by the absence of the tonsils and adenoids. In most cases additional exercises for the palate are not needed in order to achieve the closure. However, blowing exercises can speed up the process and ensure a quicker recovery. Please remember, it is important to wait until the healing process is complete to start blowing exercises! This usually takes about 2-3 weeks.
Try a kazoo!
Blowing a kazoo is the exercise I have found to be the most beneficial for strengthening the soft palate for the purpose of eliminating hypernasal speech. It is effective because it requires the blower to use voice in addition to blowing. When the blower uses this combination of both voice and air it stimulates the soft palate to close off the nasal passage. Subsequent blowing on the kazoo strengthens and lengthens the soft palate eventually leading to the elimination of the hypernasal vocal quality. For this exercise to be the most effective the child should be supervised by an adult to make sure he/she does not bite the kazoo or wrap their tongue around the kazoo (lips only). In addition the kazoo should be blown at least 25 times daily for a period of at least 1-2 seconds per blow with a one second break in between.
You may also try having the child puff up the cheeks, or practice multiple repetitions of the /p/ and /b/ sounds.
Contact an ENT or SLP if :
If you don’t see results within a 2-3 months from starting these exercises you should follow up with your ENT. He/she may recommend you see a Speech-Language Pathologist for more help.
More Information:
I am still trying to find more information regarding hypernasality following this surgery. These are the best articles I have found so far:
“Hypernasality: a voice or resonance disorder?” Children’s Healthcare of Atlanta
“Tonsillectomies-Adenoidectomies” University of Tenessee
I hope this helps.
5 Responses to “Tonsillectomy-Adenoidectomy and Hypernasality”
Leave a Reply
I am a licensed Speech Language Pathologist and have been working in this field since 2000. I am also a mother to four wonderful kids who keep me busier than ever! I put together this blog to share some of the tips and techniques that have worked for me over the years in teaching kids to improve their speech and more effectively communicate. Thanks for reading and remember it takes time and patience with this stuff but it is so worth it!
Can you tell me how many times exactly we have to do it? You mentioned 25 times a day. But approximately how many days?
Hi Pragnesh,
Thanks for your comment. If you are experiencing hyper nasality following a surgery be sure to wait until you are completely healed before beginning any exercises. If you are experiencing continued hyper nasality after you have healed completely try the kazoo for a few weeks. If you do not see any progress after a few weeks contact your ENT for a follow up evaluation. He may have some other exercises or recommendations that will help correct the hyper nasality. I would love to hear how it goes if you would be willing to come back and share your experience with us.
Wishing you the best,
Heidi
Thank You so much for replying back Heidi. I haven’t gotten any surgeries done. I just noticed it recently that sometimes when I say words it comes out under my nose and after I came across this page, I thought that maybe since maybe my soft palate is weak that’s why.
As far as therapy goes, I have seen a therapist where I live and I have gotten an evaluation done. Before I go to her, I want to know all of the things I do wrong when I speak so that makes our sessions much more valuable. Speech therapy is very expensive and I dont want to spend most of the time in finding out what’s wrong when I can just research on this site. :)
Hi Heidi.I am writing you from Macedonia considering a problem that I have with my son…You see he had a adenoidectomy and tonsillectomy a year ago and still have the nasal speech…Please give me some advice what to do because frenkly I am loosing hope that he will get better.:(((.Thanks
I would recommend you take him in for a follow up examination with the doctor that performed the procedure to make sure that structurally he has the ability to close off the nasal passage. If he structurally has the ability to close off the nasal passage and it is just an issue of strengthening the soft palate to close off the nasal passage then I would recommend you see a speech language pathologist to guide you through some exercises to help strengthen the soft palate to eliminate the hyper nasal speech. In the mean time any exercises that you can do to encourage oral air flow will help strengthen the soft palate. For example blowing cotton balls across a table, blowing a pin wheel, blowing bubbles, horns and kazoos. I hope this helps.
Best of luck!
Heidi