Otologic Outcomes With Two Different Surgical Protocols in Patients With a Cleft Palate

D’Andréa, Gregoire; Maschi, Claude; Savoldelli, Charles; Caci, Hervé; Bailleux, Sonanda

doi:10.1177/1055665618758686

Cited by 13 publications

(16 citation statements)

References 34 publications

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“…The number of participants who had grommets inserted (41%) is high compared with 18.9% reported by Gani et al (2012), but similar to the 39.3% reported by D’Andrea et al (2018) after the Sommerlad technique and 45.5% reported on national UK data by Fitzsimons et al (2017). The high numbers of grommet insertion reported in this study reflects historical practice.…”

Section: Discussionsupporting

confidence: 77%

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

Baillie

Sell

2020

The Cleft Palate Craniofacial Journal

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Objective: To report speech and velopharyngeal function (VPF) outcomes, and surgical characteristics, at age 5 following early complete palate closure using the Sommerlad protocol. Design: A retrospective, descriptive, cross-sectional consecutive series. Setting: A regional twin site center; a district general hospital and tertiary children’s hospital. Participants: Between 1993 and 2006, 877 participants underwent surgery; 712 (81%) were eligible for inclusion; 391 (55%) were included, 321 (45%) excluded. Thirteen percent had bilateral cleft lip and palate (CLP), 40% unilateral CLP, and 47% isolated cleft palate. Intervention: Lip and vomerine flap repair at 3 months of age (BCLP, UCLP) with soft palate closure using radical muscle dissection and retropositioning at a mean age of 6.6 months, range 4 to 23 months, as described and undertaken by Sommerlad. Outcome Measures: Velopharyngeal Composite (VPC) CAPS-A and articulation summary scores derived from analysis using the Cleft Audit Protocol for Speech-Augmented. Results: A VPC-SUM CAPS-A score of “0” was found in 97% reflecting adequate VPF; 73% had no cleft articulation difficulties. The BCLP group had the poorest articulation. Secondary speech surgery rate was 2.6% and 10.7% had fistula repair. Levator muscle quality and degree of retropositioning was associated with speech outcomes related to VPF. 2.6% had current features of VPI. Conclusions: Complete palate closure by around 6 months of age by the surgeon who described the technique led to excellent perceived VPF and very good speech outcomes at age 5, with less speech therapy and secondary speech surgery than commonly reported. These findings serve as a benchmark for the Sommerlad protocol and technique.

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Section: Discussionsupporting

confidence: 77%

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

Baillie

Sell

2020

The Cleft Palate Craniofacial Journal

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“…Similarly, other studies corroborated that palatal muscle reconstruction and relocation decrease the rate of eustachian tube dysfunction [16,17]. Brgoch et al and D'Andréa et al emphasized the role of Sommerlad IVVP in reducing the incidence need of ventilation tube placement [11,18]. On the contrary, Mantilla et al suggested the combination of palatoplasty and ventilation tube insertion.…”

Section: Discussionmentioning

confidence: 89%

“…It shows that the applied method performed significantly in the improvement of the middle ear effusion. Several studies approved the effect of palatoplasty in reducing the incidence of OME, while they did not find any statistically significant correlation between the surgical technique and the reducing impact on middle ear effusion [11][12][13][14]. On the other hand, Hassan et al reported that Sommerlad IVVP was associated considerably with a lower incidence of OME in comparison with the (Veau-Wardill-Kilner) VWK palatoplasty [15].…”

Section: Discussionmentioning

confidence: 99%

The Effect of Intervelar Veloplasty Under Magnification (Sommerlad’s Technique) Without Tympanostomy on Middle Ear Effusion in Cleft Palate Patients

et al. 2022

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“…It shows that the applied method performed significantly in the improvement of the middle ear effusion. Several studies approved the effect of palatoplasty in reducing the incidence of OME, while they did not find any statistically significant correlation between the surgical technique and the reducing impact on middle ear effusion [ 11 – 14 ]. On the other hand, Hassan et al reported that Sommerlad IVVP was associated considerably with a lower incidence of OME in comparison with the (Veau-Wardill-Kilner) VWK palatoplasty [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, other studies corroborated that palatal muscle reconstruction and relocation decrease the rate of eustachian tube dysfunction [ 16 , 17 ]. Brgoch et al and D’Andréa et al emphasized the role of Sommerlad IVVP in reducing the incidence need of ventilation tube placement [ 11 , 18 ].…”

Section: Discussionmentioning

confidence: 99%

The effect of intervelar veloplasty under magnification (Sommerlad’s Technique) without tympanostomy on middle ear effusion in cleft palate patients

et al. 2021

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Objective Different surgical techniques and management approaches have been introduced to manage the cleft palate (CP) and its complications, such as otitis media with effusion (OME) and auditory problems. The optimal method, as well as the ideal time for palatoplasty and ventilation tube insertion, are the subject of controversy in the literature. We aimed to evaluate The Effect of Intervelar Veloplasty under Magnification (Sommerlad’s Technique) without Tympanostomy on Middle Ear Effusion in Cleft Palate Patients. Methods non-syndromic cleft palate patients from birth to 24 months who needed primary palatoplasty from April 2017 to 2019 were enrolled in this study. intravelar veloplasty (IVVP) surgery under magnification has been done by the same surgeon. Likewise, Otoscopy, Auditory Brainstem Response (ABR), and tympanometry were performed for all the patients before and six months after palatoplasty. Results Tympanograms were classified into two categories according to shape and middle ear pressure, and it was done in 42 children (84 ears). Type B curve was seen in 40 cases (80 ears) before surgery which reduced significantly (P < 0.005) to 12 cases in the left ear and 14 cases in the right ear after surgery. So, after surgery, 70 % of the tympanogram of left ears and 66.6 % of the tympanogram of Rt ears were in normal condition (type A tympanometry). ABR was done for 43 patients (86 ears) before surgery and six months after palatoplasty. Data were shown that 40 of the patients had mild to moderate hearing loss before surgery, which reduced significantly (P < 0.005) to 9 in the left ear and 11 in the right ear after palatoplasty. So, after surgery, 79 % of ABR of left ears and 73.8 % of ABR of right ears were in normal status (normal hearing threshold). Conclusions Intervelar veloplasty under magnification (Sommerlad’s technique) significantly improved the middle ear effusion without the need for tympanostomy tube insertion.

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Otologic Outcomes With Two Different Surgical Protocols in Patients With a Cleft Palate

Abstract: Early Sommerlad intravelar veloplasty may reduce persistent OME and consequently the need for ventilation tubes insertion, compared to later Veau-Wardill-Kilner palatoplasty.

Cited by 13 publications

References 34 publications

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

Benchmarking Speech, Velopharyngeal Function Outcomes and Surgical Characteristics Following the Sommerlad Protocol and Palate Repair Technique

The Effect of Intervelar Veloplasty Under Magnification (Sommerlad’s Technique) Without Tympanostomy on Middle Ear Effusion in Cleft Palate Patients

The effect of intervelar veloplasty under magnification (Sommerlad’s Technique) without tympanostomy on middle ear effusion in cleft palate patients

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