Severe velopharyngeal stenosis following repeated adenotonsillectomy in a child: a rare diagnostic and surgical challenge

Severe complications following tonsillectomy are rare in the pediatric population. However, repeated oropharyngeal surgeries can occasionally result in velopharyngeal stenosis. We report the case of a 7-year-old patient from Côte d'Ivoire who underwent two tonsillectomies 5 months apart, along with an adenoidectomy. Subsequently, she developed hypernasal speech, chronic nasal obstruction, dysphagia to solids, and mild respiratory discomfort. Nasal endoscopy revealed a postoperative velopharyngeal stenosis characterized by fibrous narrowing between the soft palate and the posterior pharyngeal wall. A corrective surgical procedure was performed, including dissection of fibrous adhesions and anatomical reconstruction of the soft palate. The postoperative course was favorable, with improved phonation, resolution of respiratory symptoms, and disappearance of dysphagia. This rare case highlights the importance of early endoscopic diagnosis and appropriate surgical management to prevent long-term functional sequelae.