Pharynx and tonsils: pharyngeal flap for velopharyngeal insufficiency: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Pharynx and tonsils: pharyngeal flap for velopharyngeal insufficiency

Sample item

A 6-year-old who had cleft palate repair has persistent hypernasal speech with nasal air escape and a gap on speech nasendoscopy. Speech therapy has failed. Which surgery is most suitable?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Pharyngeal flap or sphincter pharyngoplasty

Persistent velopharyngeal insufficiency after palate repair is managed surgically when therapy fails, using a pharyngeal flap or sphincter pharyngoplasty to narrow the velopharyngeal port. Adenoidectomy can worsen the gap because the pad helps closure.

Option by option

  • A. Adenoidectomy

    Removing adenoid tissue enlarges the gap and tends to worsen hypernasality.

  • B. Pharyngeal flap or sphincter pharyngoplasty (correct)

    Correct. These operations reduce the velopharyngeal gap and improve nasal air escape.

  • C. Uvulopalatopharyngoplasty

    UPPP is for snoring and sleep apnoea and may cause insufficiency, not cure it.

  • D. Tonsillectomy

    Tonsillectomy does not change velopharyngeal closure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is B, Pharyngeal flap or sphincter pharyngoplasty. Persistent velopharyngeal insufficiency after palate repair is managed surgically when therapy fails, using a pharyngeal flap or sphincter pharyngoplasty to narrow the velopharyngeal port.

Why is "Adenoidectomy" not the answer?

Removing adenoid tissue enlarges the gap and tends to worsen hypernasality.

Why is "Uvulopalatopharyngoplasty" not the answer?

UPPP is for snoring and sleep apnoea and may cause insufficiency, not cure it.

Why is "Tonsillectomy" not the answer?

Tonsillectomy does not change velopharyngeal closure.

What concept does this question test?

It tests Pharynx and tonsils: pharyngeal flap for velopharyngeal insufficiency in ENT. Adenoidectomy can worsen the gap because the pad helps closure.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pharynx and tonsils: pharyngeal flap for velopharyngeal insufficiency?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.