Background: Adenoid hypertrophy alters the posture of the oro-facial structures by obstructing the upper airways and restricting nasal breathing. These postural changes may eventually have an impact on facial skeletal development and dental occlusion. The postural adjustments may negatively impact a child’s life by affecting a number of speech-production factors.

Objective: This study aimed to detect the speech sound disorders in school aged Egyptian children with adenoid hypertrophy and if they were related to structure changes in the airway that caused by adenoid hypertrophy.

Methods: 300 school-aged Egyptian children aged from (5–15) years old with speech sound disorders (SSD). They were divided into 2 groups; Group 1 consisted of 150 children with speech (SSD) and adenoid hypertrophy, and Group 2 consisted of 150 children complained from (SSD) without adenoid hypertrophy. All children were evaluated by protocol of language assessment and articulation test used in Assiut University Hospital.

Results: Speech sound disorders (SSD) mainly the omission and distortion are more frequent in (group 2) while, the sub­stitution errors are more prominent in (group 1). The interdental sigmatism was the most frequent speech sound disorder in (group 1) especially those with adenoid hypertrophy occupying more than 50% of the airway, whereas, devoicing, gliding and back to front are more frequent in (group 2).

Conclusions: Adenoid hypertrophy can affects only the /s/ sound production which needs precise placements of the articula­tors especially the tongue, and seems to be vulnerable due to the structural alteration of the oral cavity caused by adenoid hypertrophy.