Speech Outcomes after Tonsillectomy in Patients with Known Velopharyngeal Insufficiency

Paulson, Lorien M.; MacArthur, Carol J.; Beaulieu, Kim; Brockman, Janet H.; Milczuk, Henry A.

doi:10.1155/2012/912767

Cited by 12 publications

(9 citation statements)

References 14 publications

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“…No sleep studies were performed in either study. Tonsillectomy, on the other hand, does not appear to significantly affect velo-pharyngeal competence or speech intelligibility (77). …”

Section: Treatment Of Osa In Children With Cleft Lip/palatementioning

confidence: 99%

Craniofacial syndromes and sleep-related breathing disorders

Tan

Kheirandish‐Gozal

Abel

et al. 2016

Sleep Medicine Reviews

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Summary Children with craniofacial syndromes are at risk of sleep disordered breathing, the most common being obstructive sleep apnea. Midface hypoplasia in children with craniosynostosis and glossoptosis in children with Pierre Robin syndrome are well recognized risk factors, but the etiology is often multifactorial and many children have multilevel airway obstruction. We examine the published evidence and explore the current management strategies in these complex patients. Some treatment modalities are similar to those used in otherwise healthy children such as as adenotonsillectomy, positive pressure ventilation and in the refractory cases, tracheostomy. However, there are some distinct approaches such as nasopharyngeal airways, tongue lip adhesion, mandibular distraction osteogenesis in children with Pierre Robin sequence, and midface advancement in children with craniosynostoses. Clinicians should have a low threshold for referral for evaluation of sleep-disordered-breathing in these patients.

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“…No sleep studies were performed in either study. Tonsillectomy, on the other hand, does not appear to significantly affect velo-pharyngeal competence or speech intelligibility (77). …”

Section: Treatment Of Osa In Children With Cleft Lip/palatementioning

confidence: 99%

Craniofacial syndromes and sleep-related breathing disorders

Tan

Kheirandish‐Gozal

Abel

et al. 2016

Sleep Medicine Reviews

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“…Currently, routine, prophylactic adenotonsillectomy is not standard practice, as this additional intervention has associated risks and costs to patients. Furthermore, the literature does not convincingly demonstrate a reduced rate of OSA following prophylactic adenotonsillectomy, and adenotonsillectomy, separately, has been demonstrated to cause VPD in some patients, attributed to tissue stiffness and scaring (Reath et al, 1987; Randall et al, 1998; Chegar et al, 2007; Paulson et al, 2012). The answer to this question ultimately comes down to surgeon preference: balancing the positive and negative effects on airway anatomy and physiology, cost, and risks of an additional procedure under general anesthesia, as well as inconvenience to families.…”

Section: Discussionmentioning

confidence: 99%

Defining Risk of Postoperative Obstructive Sleep Apnea in Patients With 22q11.2DS Undergoing Pharyngeal Flap Surgery for Velopharyngeal Dysfunction Using Polysomnographic Evaluation

Lee

Chang

Solot

et al. 2020

The Cleft Palate-Craniofacial Journal

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Objective: To determine pre- and postoperative prevalence of obstructive sleep apnea (OSA) in patients with 22q11.2 deletion syndrome (DS) undergoing wide posterior pharyngeal flap (PPF) surgery for velopharyngeal dysfunction (VPD). Design: Retrospective study using pre- and postoperative polysomnography (PSG) to determine prevalence of OSA. Medical records were reviewed for patients’ medical comorbidities. Parents were surveyed about snoring. Setting: Academic tertiary care pediatric hospital. Patients: Forty patients with laboratory confirmed 22q11.2DS followed over a 6-year period. Interventions: Pre- and postoperative PSG, speech evaluation, and parent surveys. Main Outcome Measure: Severity and prevalence of OSA, defined by obstructive apnea hypopnea index (OAHI), before and after PPF surgery to determine whether PPF is associated with increased risk of OSA. Results: Mean OAHI did not change significantly after PPF surgery (1.1/h vs 2.1/h, P = .330). Prevalence of clinically significant OSA (OAHI ≥ 5) was identical pre- and postoperatively (2 of 40), with both cases having severe-range OSA requiring positive airway pressure therapy. All other patients had mild-range OSA. Nasal resonance was graded as severe preoperatively in 85% of patients. None were graded as severe postoperatively. No single patient factor or parent-reported concern predicted risk of OSA (OAHI ≥ 1.5). Conclusions: Patients with 22q11.2DS are medically complex and are at increased risk of OSA at baseline. Wide PPF surgery for severe VPD does not significantly increase risk of OSA. Careful perioperative planning is essential to optimize both speech and sleep outcomes.

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“…13 (2011) di USA juga menyatakan distribusi terbanyak pada jenis kelamin laki-laki (56,52%). 14 Penderita yang menjalani tonsilektomi pada penelitian ini datang dengan keluhan utama terbanyak adalah nyeri pada tenggorok yaitu 12 pasien (57,2%), sakit saat menelan sebanyak 7 pasien (33.3%), dan mendengkur 2 pasien (9.5%). Hasil penelitian ini sesuai dengan SIGN (Scottish Intercollegiate Guidelines Network) (2010), keluhan utama yang sering pada penderita tonsilitis kronis yang diindikasikan tonsilektomi adalah nyeri tenggorokan sebanyak 58,3% per 1.000 populasi.…”

Section: Pembahasanunclassified

Karakteristik Dan Ukuran Tonsil Pasien Tonsilektomi Di Instalsi Bedah Sentral Rumah Sakit Umum Provinsi NTB Bulan Juli Tahun 2019

Yuliyani¹,

Kadriyan²,

Yudhanto³

et al. 2022

JKU

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Latar belakang: Tonsilitis kronis secara umum diartikan sebagai infeksi atau inflamasi pada tonsil palatina yang menetap. Pembesaran tonsil dapat menyebabkan beberapa komplikasi yang dapat menjadi indikasi dilakukanya operasi tonsilektomi. Tujuan dari penelitian ini adalah untuk mengetahui karakteristik dan ukuran tonsil pasien tonsikeltomi di Instalasi Bedah Sentral Rumah Sakit Umum Provinsi Nusa Tenggara Barat bulan Juli tahun 2019. Metode: Penelitian ini merupakan penelitian deskriptif retrospektif, dengan teknik consecutive sampling, menggunakan data sekunder pasien yang telah ada di RSUD Provinsi NTB bulan Juli 2019 kemudian di analisis dan disajikan dalam bentuk tabel dan narasi. Didapatkan 21 pasien yang menjalani tonsilektomi di IBS RSUP NTB selama bulan Juli 2019. Hasil: Distribusi berdasarkan tingkat umur nampak bahwa penderita tonsilektomi, sebagian besar adalah tergolong anak-anak yang berkisar pada umur 5-10 tahun. Berdasarkan jenis kelamin yang terbanyak adalah perempuan sebanyak 11 orang (52,4%).Penderita yang menjalani tonsilektomi lebih banyak karena indikasi relatif sebesar 19 pasien (90,5%) dengan keluhan utama terbanyak adalah nyeri pada tenggorok yaitu 12 orang (57,2%). Penderita tonsilitis kronis paling banyak mengalami pembesaran tonsil dengan ukuran tonsil T3-T3 yaitu 13 orang(61.9%). Kesimpulan: Dominasi indikasi melakukan tonsilektomi adalah indikasi relatif, yaitu keluhan yang berulang. Pasien yang menjalani operasi tonsilektomi paling banyak mengalami pembesaran ukuran tonsil T3/T3 dengan insiden tonsilektomi yang tinggi pada kelompok umur 5-10 tahun.

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Speech Outcomes after Tonsillectomy in Patients with Known Velopharyngeal Insufficiency

Cited by 12 publications

References 14 publications

Craniofacial syndromes and sleep-related breathing disorders

Craniofacial syndromes and sleep-related breathing disorders

Defining Risk of Postoperative Obstructive Sleep Apnea in Patients With 22q11.2DS Undergoing Pharyngeal Flap Surgery for Velopharyngeal Dysfunction Using Polysomnographic Evaluation

Karakteristik Dan Ukuran Tonsil Pasien Tonsilektomi Di Instalsi Bedah Sentral Rumah Sakit Umum Provinsi NTB Bulan Juli Tahun 2019

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