Concomitant adenotonsillectomy and cleft palate repair in one sitting

Area of Science:

• Pediatric Otolaryngology
• Craniofacial Surgery
• Speech Pathology

Background:

• Adenotonsillar hypertrophy (ATH) presents a surgical challenge during cleft palate (CP) repair.
• The decision for concurrent adenotonsillectomy requires careful consideration of potential impacts on speech and breathing.

Purpose of the Study:

• To evaluate the effectiveness of adenotonsillectomy performed concurrently with cleft palate repair in children with ATH.
• To assess the impact on both speech and breathing outcomes.

Main Methods:

• Nine children with CP and ATH underwent simultaneous adenotonsillectomy and palatoplasty.
• Speech and velopharyngeal function were evaluated using auditory perceptual assessment and nasometry at age 4.

Main Results:

• No postoperative obstructive breathing episodes were reported by parents.
• Six patients had normal nasality, three had mild hypernasality; nasalance scores were comparable to controls.
• Velopharyngeal closure was competent in 4, borderline in 3, and borderline incompetent in 2 patients.

Conclusions:

• Concurrent adenotonsillectomy during cleft palate repair is safe for speech.
• This procedure effectively prevents obstructive breathing episodes post-surgery in children with ATH.