Department of Otolaryngology, Faculty of Medicine, Cairo University, el-salam st., King Faisal, above el-baraka bank, Giza, Cairo, Egypt.
Department of Otolaryngology, Aswan University, Aswan, Egypt.
Eur Arch Otorhinolaryngol. 2020 Apr;277(4):1133-1137. doi: 10.1007/s00405-020-05814-1. Epub 2020 Jan 25.
When adenotonsillar hypertrophy (ATH) is encountered in children during cleft palate (CP) repair, the decision for adenotonsillectomy is challenging. The aim of this study was to evaluate the effectiveness of adenotonsillectomy done during CP repair for children with ATH on speech and breathing.
Nine children with CP and ATH underwent adenotonsillectomy prior to palatoplasty in same sitting. The age of patients ranged between 1.5 and 3.5 years with a mean age of 2.3 years at the time of operation. Auditory perceptual assessment (APA), nasometric assessment, and velopharyngeal function evaluation were performed when the children reached the age of 4 years.
No children developed obstructive breathing episodes postoperatively as witnessed by parents. APA showed normal nasality in six patients and mild hypernasality in three patients. Nasalance scores for both nasal and oral sentences were found to be comparable with that of normal children of the same age. Velopharyngeal closure was seen competent in four patients, borderline competent in three patients, and borderline incompetent in two patients.
Performing adenotonsillectomy during CP repair does not deleteriously affect the speech and it prevents the occurrence of postoperative obstructive breathing episodes that may be caused by the hypertrophied tonsils and/or adenoid.
在腭裂修复过程中遇到儿童腺样体扁桃体肥大（ATH）时，进行腺样体扁桃体切除术的决策具有挑战性。本研究旨在评估在腭裂修复期间对伴有 ATH 的儿童进行腺样体扁桃体切除术对其言语和呼吸功能的有效性。
9 例 ATH 合并 CP 的儿童在腭裂修复术同期行腺样体扁桃体切除术。患者年龄为 1.5 岁至 3.5 岁，平均手术年龄为 2.3 岁。当儿童达到 4 岁时，进行听觉感知评估（APA）、鼻音计评估和腭咽功能评估。
父母观察到所有儿童术后均未出现阻塞性呼吸事件。APA 显示 6 例患儿有正常鼻音，3 例患儿有轻度鼻音过度。鼻和口腔句子的鼻音计评分与同龄正常儿童相当。4 例患儿腭咽闭合功能正常，3 例患儿为临界正常，2 例患儿为临界异常。
在 CP 修复期间进行腺样体扁桃体切除术不会对言语产生不利影响，并可预防因肥大的扁桃体和/或腺样体引起的术后阻塞性呼吸事件。
