Tonsillectomy-Adenoidectomy and Hypernasality

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.