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Endoscopic partial adenoidectomy for children with submucous cleft palate
Yehuda Finkelstein1, David B Wexler, Ariela Nachmani
1Palate Surgery Unit of the Department of Otolaryngology-Head and Neck Surgery, Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel. fiyehuda@netvision.net.il
Summary
Transnasal endoscopic partial adenoidectomy effectively relieved nasal obstruction in children with cleft palate and enlarged adenoids. This technique preserved velopharyngeal function, improving breathing and speech without significant side effects.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Speech Pathology
Background:
- Submucous cleft palate often coexists with adenoid hypertrophy, causing nasal obstruction.
- Adenoidectomy in these patients is cautiously approached due to concerns about velopharyngeal insufficiency.
- Normal nasal breathing is crucial for childhood development.
Purpose of the Study:
- To evaluate the efficacy of transnasal endoscopic horizontal partial adenoidectomy.
- To assess the impact on nasal obstruction and velopharyngeal function in children with submucous cleft palate.
Main Methods:
- Ten children (3.5-13 years) with submucous cleft palate and adenoidal hypertrophy underwent the procedure.
- Transnasal endoscopic horizontal partial adenoidectomy was performed, focusing on the lower third of the choanae.
Main Results:
- All patients achieved nasal breathing post-surgery.
- Hyponasality resolved, and speech intelligibility normalized.
- Mild hypernasality occurred in two patients, but overall speech was improved.
Conclusions:
- Transnasal endoscopic horizontal partial adenoidectomy is a viable option for managing adenoid hypertrophy in children with submucous cleft palate.
- The procedure effectively alleviates nasal obstruction while maintaining velopharyngeal valve function.