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

Česká verzia

Authors: Z. Dvořák ^1,2; P. Horník ³
Authors place of work: 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 the journal: Čes-slov Pediat 2019; 74 (6): 339-348.
Category: Original Papers

Summary

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

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