This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Pharynx, Subject name: ENT
Adenoidectomy is contraindicated in: 
Select and explain. 
A. Large adenoids, B. Large tonsils, C. Cleft lip, D. Cleft palate
D: Cleft palate
Answer: D: Cleft palate 
Explanation: (d) Cleft palate(Ref. Scott Brown, 6th ed., 6/18/12)Adenoidectomy in a child with cleft palate will lead to nasopharyngeal/velopharyngeal insufficiency so it is a contraindication.Large adenoids causing complications as discussed in the text is an indication of adenoidectomy.In a child who is simultaneously suffering due to large tonsils, tonsillectomy is done along with adenoidectomy in the same sitting.Cleft lip does not lead to nasopharyngeal/ velopharyngeal insufficiency after adenoidectomy.