Abstract
Summary 1.Between 1951 and 1968 a personal series of 19 patients have been examined who after removal of tonsils and adenoids suffered permanent nasal escape during speech. 2.All had had normal speech before operation and were of above average intelligence. 3.The main defects in speech were audible nasal escape and loss of voice projection. 4.Radiological studies always demonstrated a fully mobile soft palate but with a gap between it and the posterior pharyngeal wall. When this gap was occluded by a cartilage implant behind the posterior wall of the pharynx speech returned to normal. 5.Cephalometric measurements suggest that the essential defect is a pharynx deeper than normal, but that such disproportion between palate and pharynx is probably not possible to diagnose before adenoidectomy.
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