My 6 year old son has been diagnosed by a speech pathologist as having moderate stuttering. She also notices a nasal quality in his speech. We are having a nasal endoscopy done in 1 week to see if his adenoids are enlarged (possibly impeding airflow?) and to check the condition of his soft palate. Two questions: Have you ever seen structural problems like these that have affected speech, particulary stuttering? Also, how can I prepare my 6 year old for this procedure - what should I tell him about what will happen, how long it will last (please tell me it will be short!!) and how it will feel to him.
Reply: ----------------------------------
First of all, I am not aware of any relationship between stuttering and anatomic abnormalities such as adenoidal hypertrophy. The only speech abnormality that would be directly associated with an adenoidal hypertrophy is known as hyponasal speech. I am not clear as to the indication for nasal endoscopy - it is rarely necessary to require endoscopy in order to determine whether or not significant adenoidal hypertrophy is present. On the other hand if there is concern regarding palate function or if there is concern regarding intranasal or nasopharyngeal abnormalities other than adenoidal hypertrophy, then certainly nasal endoscopy is the recommended procedure. Nasal endoscopy is a very minor procedure but does require some preparation in a child. Occasionally I recommend mild sedation in a child of this age. It will require at the very least some topical anesthesia such as xylocaine to "numb" the lining of the nose.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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