Trans-oral endoscopic partial adenoidectomy does not worsen the speech after cleft palate repair

Abdel‐Aziz, Mosaad; Khalifa, Badawy; Shawky, Ahmed M.; Rashed, Mohamed; Naguib, Nader; Abdel-Hameed, A.

doi:10.1016/j.bjorl.2015.08.025

Cited by 10 publications

(6 citation statements)

References 20 publications

(32 reference statements)

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“…In children with CL/P, adenoidectomy is often avoided to prevent aggravation of speech problems [19]. In the present study, adenoidectomy was performed in none of the children with CL/P.…”

Section: Discussionmentioning

confidence: 99%

Oral habits in Children with Cleft (Lip and) Palate: A Pilot Study

Alighieri

Bettens

Bonte

et al. 2019

Folia Phoniatr Logop

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Background/Aims: This pilot study aimed to evaluate the occurrence of oral habits and non-nutritive sucking habits in children with cleft (lip and) palate (CL/P) between 0–12 years, compared to peers without CL/P. Methods: Children with CL/P (mean age 6.0 years, SD 2.80) were recruited from the Ghent University Hospital and compared to gender- and age-matched children without CL/P (mean age 5.8 years, SD 3.09). A self-report questionnaire was developed and given to the caregivers. To compare the occurrence of oral habits and non-nutritive sucking habits in children with and without CL/P, χ² tests or Fisher’s exact tests were used. Results: The present study revealed a significantly lower occurrence of non-nutritive sucking habits in children with CL/P. These children showed significantly less pacifier sucking; no significant difference was found regarding thumb or finger sucking nor regarding sucking on other objects. Additionally, the results showed that the occurrence of snoring was statistically significantly higher in children with CL/P. Conclusion: Children with CL/P show less non-nutritive sucking habits, but more snoring compared to a control group without CL/P. Although further research regarding the oral habits in children with CL/P is necessary, cleft teams should give attention to the occurrence of oral habits.

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“…In children with CL/P, adenoidectomy is often avoided to prevent aggravation of speech problems [19]. In the present study, adenoidectomy was performed in none of the children with CL/P.…”

Section: Discussionmentioning

confidence: 99%

Oral habits in Children with Cleft (Lip and) Palate: A Pilot Study

Alighieri

Bettens

Bonte

et al. 2019

Folia Phoniatr Logop

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“…Many studies have already compared TA and PEA, showing how power-assisted techniques improve management of adenoidectomy in terms of pain, blood loss, recovery and surgical time, and completeness of adenoid removal, albeit in small patient cohorts 14,15 . On the other hand, other authors showed that, although PEA outcomes are superior to TA, subjectively no differences emerged between the two methods 11 , and PEA becomes the technique of choice only in specific setting such as cleft lip and palate patients 13 . On this basis, and given the aforementioned literature debate, it seems important to keep developing the technique and sharing scientific evidence, especially if we take into account that adenoidectomy is performed annually in tens of thousands of children.…”

Section: Introductionmentioning

confidence: 98%

“…Overall, PEA allows a safer, more manageable and functional procedure. Though PEA is widely described in scientific literature, only relatively small case series are available [9][10][11][12] and the procedure itself has never really taken a hold in otolaryngological practice, with the notable exception of endoscopic adenoidectomy for cleft lip and/or palate patients 13 . Many studies have already compared TA and PEA, showing how power-assisted techniques improve management of adenoidectomy in terms of pain, blood loss, recovery and surgical time, and completeness of adenoid removal, albeit in small patient cohorts 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic adenoidectomy: a systematic analysis of outcomes and complications in 1006 patients

Saibene

Rosso

Pipolo

et al. 2020

Acta Otorhinolaryngol Ital

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Adenoid hypertrophy (AH) is an extremely common condition in the paediatric population, relating to different pathological scenarios. Failure in responding to medical therapy often leads to adenoidectomy. While traditional adenoidectomy is indeed a relatively "blind" procedure, endoscopic procedures allow more radical resections, bleeding monitoring and complete Eustachian tube sparing, making adenoidectomy a safer, more manageable and functional procedure. Though the literature widely describes endoscopic adenoidectomy, only small case series are available and the procedure itself has never really taken hold in routine otolaryngology practice. The aim of this article is to report data on endoscopic adenoidectomy in a large single centre patient population. We retrospectively evaluated the medical records of 1006 children who underwent endoscopic adenoidectomy with or without tonsillectomy (respectively 493 and 513 patients). Data on surgical time, blood loss, hospital stay, short and long-term complications, recurrences and post-operative pain were collected. Our analysis showed that the endoscopic approach requires a longer surgical time, but it is associated with less intraoperative blood loss, a lower complication rate and less treatment failures compared to large contemporary case series of either traditional or power-assisted approaches. The overall better outcomes are more noticeable when comparing our data with classic technique case series than with power-assisted case series. Endoscopic adenoidectomy should therefore be regarded as a valid technique, which, in expert hands, lowers the rates of complications and recurrences at the expense of a slightly increased surgical time.

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“…Performing endoscopy- (and power-) assisted selective peri-tubal adenoidal resections has, in turn, become the gold standard in this patient group [ 22 ]. This change became reality as endoscopy-assisted adenoidectomy turned into a reliable tool in the general pediatric population in the 90 s. Endoscopic evaluation of the surgical field allows for selective adenoidectomy and has been widely demonstrated as a safe and reproducible tool also in the CP ± L population with no detrimental effect on speech [ 23 ] and VPI [ 13 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

“…Endoscopic visualization of the nasopharynx can be also obtained via oral access, as showed in several studies [ 22 , 23 ] in which a superior partial adenoidectomy is performed with cold or powered instruments with the aid of a transoral 70° endoscope. Abdel-Aziz et al [ 22 ] claim that the transoral approach enables the surgeon to efficiently inspect the velopharyngeal valve during adenoidectomy, allowing to assess which portion of the adenoidal tissue contributes the most to velopharyngeal closure.…”

Section: Methodsmentioning

confidence: 99%

Adenoidectomy for middle ear disease in cleft palate children: a systematic review

Rosso

Bulfamante

Pipolo

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

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Trans-oral endoscopic partial adenoidectomy does not worsen the speech after cleft palate repair

Cited by 10 publications

References 20 publications

Oral habits in Children with Cleft (Lip and) Palate: A Pilot Study

Oral habits in Children with Cleft (Lip and) Palate: A Pilot Study

Endoscopic adenoidectomy: a systematic analysis of outcomes and complications in 1006 patients

Adenoidectomy for middle ear disease in cleft palate children: a systematic review

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