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Functional results of patients with cleft palate between 1993 and 2006 in Moravia III – ENT results


Authors: Z. Dvořák 1,2;  P. Horník 3
Authors‘ workplace: Lékařská fakulta Masarykovy Univerzity, Brno 1;  Klinika plastické a estetické chirurgie FN U sv. Anny, Brno 2;  Dětská ORL, s. r. o., Brno 3
Published in: Čes-slov Pediat 2019; 74 (6): 339-348.
Category: Original Papers

Overview

Objective: To evaluate the results of palatal reconstruction in children with cleft palate based on the therapeutic results of the multidisciplinary team of the Cleft Center at the Department of Plastic and Aesthetic Surgery of St. Anna’s Faculty Hospital in Brno (KPECH) focusing on the results of ENT controls.

Material and method: The group was formed of patients with cleft palates born from January 1, 2001 to December 31, 2006 and treated at KPECH. The group included 114 patients (67 boys and 47 girls) with a monitoring period of 2 to 7 years.

Results: The preoperative incidence of chronic secretory otitis was approximately 60% in all groups of patients. The incidence of recurrent otitis media varied between 6 to 10% in all patients. The type of cleft and the gender of the patient do not significantly affect the course and consequences of chronic secretory otitis. The patients with the isolated cleft palate, patients with the Furlow procedure and patients with the early adenoidectomy have the smallest incidence of permanent hearing loss and the smallest number of ventilation tubes for the recovery of chronic secretory otitis. In patients with the early adenoidectomy, there is no difference in speech development and in the occurrence of hypernasality compared to patients who have not been adenotomized.

Conclusion: The best surgical results are achieved by Furlow's palatoplasty in patients with isolated cleft palate. The smallest number of ventilation tubes was needed at this procedure for the recovery of chronic secretory otitis. When finding adenoid vegetation II. and III. grade and type B, C it is advisable to perform adenoidectomy during the primary reconstruction of cleft palate without the risk of ipairment of speech development or greater occurence of hypernasality.

Keywords:

cleft lip – cleft palate – orofacial cleft – Eustachian tube – otitis media with effusion


Sources

1. Patrick JA. Otolaryngologic needs of individuals with oral clefts. In: Wyszynski DF (ed). Cleft Lip and Palate: From Origin to Treatment. Oxford, New York: Oxford University Press, 2002: 397–407.

2. Urík M, Macháč J. Chronický zánět středního ucha v dětském věku. Čes--slov Pediat 2017; 72 (8): 504–509.

3. Otruba L, Fuhrman L. Poruchy sluchu u rozštěpových pacientů a způsoby jejich řešení. In: Dušková M (ed). Pokroky v sekundární léčbě nemocných s rozštěpem. Hradec Králové: Olga Čermáková, 2007: 157–164.

4. Fuhrmann L, Otruba L, Dušková M. Rozštěpové vady a jejich podíl na vzniku chronické otitidy u starších dětí a adolescentů. Otorinolaryngol Foniatr 2008; 57 (1): 22–30.

5. Finkelstein Y, Talmi YP, Nachmani A, et al. Levator veli palatini muscle and eustachian tube function. Plast Reconstr Surg 1990; 85 (5): 684–692; discussion 693–697.

6. Tadinada A, Mahdian M, Porto F, et al. Cone beam CT analysis of tempora bone pneumatization in subjects with unilateral cleft lip and palate. J Mass Dent Soc 2016; 65 (2): 22–26.

7. Školoudík L, Vokurka J, Kalfeřt D, et al. Adenoidní vegetace a chronická sekretorická otitida. Otorinolaryngol Foniatr 2010; 59 (2): 62–66.

8. Tasker A, Dettmar PW, Panetti M, et al. Reflux of gastric juice and glue ear in children. Lancet 2002; 359 (9305): 493.

9. Flynn T, Möller C, Jönsson R, Lohmander A. The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts. Int J Pediatr Otorhinolaryngol 2009; 73 (10): 1441–1446.

10. Frisina A, Piazza F, Pasanisi E, et al. Cleft palate and dysfunction of the eustachian tube. Acta Bio-Medica Ateneo Parm Organo Della Soc Med E Sci Nat Parma 1998; 69 (5–6): 129–132.

11. Grant HR, Quiney RE, Mercer DM, Lodge S. Cleft palate and glue ear. Arch Dis Child 1988; 63 (2): 176–179.

12. Frans N, Scheuerle J, Bequer N, Habal MB. Middle ear tissue mass and audiometric data from otologic care of infants with cleft palate. Cleft Palate J 1988; 25 (1): 70–71.

13. Aniansson G, Svensson H, Becker M, Ingvarsson L. Otitis media and feeding with breast milk of children with cleft palate. Scand J Plast Reconstr Surg Hand Surg 2002; 36 (1): 9–15.

14. Robb PJ. Otitis media with effusion. In: Graham JM (ed). Pediatric ENT. Berlin: Springer, 2007: 413–420.

15. Fria TJ, Paradise JL, Sabo DL, Elster BA. Conductive hearing loss in infants and young children with cleft palate. J Pediatr 1987; 111 (1): 84–87.

16. Stool SE. Diseases of the ear in children with cleft palate and craniofacial anomalies. In: Cleft Lip and Palate 2006: 355–362.

17. Lalwani AK. Current Diagnosis & Treatment in Otolaryngology: Head & Neck Surgery. New York: McGraw-Hill Medical, 2008: 1–1056.

18. Broen PA, Moller KT, Carlstrom J, et al. Comparison of the hearing histories of children with and without cleft palate. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc 1996; 33 (2): 127–133.

19. Dhillon RS. The middle ear in cleft palate children pre and post palatal closure. J R Soc Med 1988; 81 (12): 710–713.

20. Doyle WJ, Reilly JS, Jardini L, Rovnak S. Effect of palatoplasty on the function of the Eustachian tube in children with cleft palate. Cleft Palate J 1986; 23 (1): 63–68.

21. Valentova S, Lehocký J, Somorová Z, et al. Vplyv rozštepových malformácií tváre na ochorenie stredného ucha. Otorinolaryngol Foniatr 2012; 61 (3): 178–183.

22. Seagle MB, Nackashi JA, Kemker FJ, et al. Otologic and audiologic status of Russian children with cleft lip and palate. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc 1998; 35 (6): 495–499.

23. Čelakovský P, Chrobok V, Vokurka J. Současné názory na léčbu chronické sekretorické otitidy – vyhodnocení dotazníkové akce. Otorinolaryngol Foniatr 1999; 48 (1): 10–14.

24. Šlapák I, Horník P, Machač J, et al. Chronická sekretorická otitis media – časné výsledky léčby zavedením ventilační trubičky. Otorinolaryngol Foniatr 1999; 48 (3): 146–149.

25. Paradise JL, Bluestone CD, Rogers KD, et al. Efficacy of adenoidectomy for recurrent otitis media in children previously treated with tympanostomy-tube placement. Results of parallel randomized and nonrandomized trials. JAMA 1990; 263 (15): 2066–2073.

26. Gates GA, Avery CA, Prihoda TJ, Cooper JC. Effectiveness of ade-noidectomy and tympanostomy tubes in the treatment of chronic otitis media with effusion. N Engl J Med 1987; 317 (23): 1444–1451.

27. Yules RB. Current concepts of treatment of ear disease in cleft palate children and adults. Cleft Palate J 1975; 12: 315–322.

28. American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics Subcommittee on Otitis Media with Effusion. Otitis media with effusion. Pediatrics 2004; 113 (5): 1412–1429.

29. Brohm F. O vývoji dětské řeči a jejich vadách. Praha: Orbis, 1956: 1–152.

30. Phua YS, Salkeld LJ, de Chalain TMB. Middle ear disease in child-ren with cleft palate: protocols for management. Int J Pediatr Otorhinolaryngol 2009; 73 (2): 307–313.

31. Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in greater Boston: a prospective, cohort study. J Infect Dis 1989; 160 (1): 83–94.

32. Robinson PJ, Lodge S, Jones BM, et al. The effect of palate repair on otitis media with effusion. Plast Reconstr Surg 1992; 89 (4): 640–645.

33. Güneren E, Ozsoy Z, Ulay M, et al. A comparison of the effects of Veau--Wardill-Kilner palatoplasty and furlow double-opposing Z-plasty operations on eustachian tube function. Cleft Palate-Craniofacial J Off Publ Am Cleft Palate-Craniofacial Assoc 2000; 37 (3): 266–270.

34. Vokurková J. Rozštěpové vady obličeje. Disertační práce. Brno: LF Masarykovy univerzity, 2000: 1–75.

35. Dvořák Z, Veselý J, Konvičková E, et al. Standardy multidisciplinární péče o dítě s rozštěpem obličeje. Čes-slov Pediat 2009; 64 (5): 236–241.

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