Mohamed E Hassan1, Sherif Askar. 1. Zagazig City, Egypt From the General Surgery Department, Pediatric Surgery Unit, and Department of Otolaryngology, Faculty of Medicine, Zagazig University.
Abstract
BACKGROUND: This study was designed to compare two-layer palatoplasty (Wardill-Kilner V-Y pushback technique) without intravelar veloplasty versus three-layer palatoplasty (Kriens technique) with intravelar veloplasty with regard to postoperative functional outcome of eustachian tube and velopharyngeal competence. METHODS: A prospective cohort study was conducted enrolling 70 patients with nonsyndromic cleft palate (except submucous type of cleft) over a period of 2 years. They were divided into two main groups according to the type of cleft palate: group A (Veau class II) included 32 patients and group B (Veau class I) included 38 patients. In each group, Wardill-Kilner palatoplasty (two-layer repair without intravelar veloplasty) versus Kriens palatoplasty (three-layer repair with intravelar veloplasty) was randomly selected for patients. RESULTS: For the three-layer palatoplasty in both groups, there was a greater tendency for resolution of secretory otitis media in the early postoperative period, less time required for extrusion of the grommet tube, and a lower incidence of recurrent secretory otitis media. The incidence of postoperative velopharyngeal incompetence was greater with two-layer palatoplasty group. The incidence of palatal fistula was greater with three-layer palatoplasty. CONCLUSIONS:Palatal muscle reconstruction in cleft palate patients confers better functional results regarding velopharyngeal competence and eustachian tube function. Although the overall incidence of postoperative palatal fistula is within the accepted range, the incidence of fistula is higher in the palatal muscle reconstruction subgroup. Future studies are required that include a larger number of patients.
RCT Entities:
BACKGROUND: This study was designed to compare two-layer palatoplasty (Wardill-Kilner V-Y pushback technique) without intravelar veloplasty versus three-layer palatoplasty (Kriens technique) with intravelar veloplasty with regard to postoperative functional outcome of eustachian tube and velopharyngeal competence. METHODS: A prospective cohort study was conducted enrolling 70 patients with nonsyndromic cleft palate (except submucous type of cleft) over a period of 2 years. They were divided into two main groups according to the type of cleft palate: group A (Veau class II) included 32 patients and group B (Veau class I) included 38 patients. In each group, Wardill-Kilner palatoplasty (two-layer repair without intravelar veloplasty) versus Kriens palatoplasty (three-layer repair with intravelar veloplasty) was randomly selected for patients. RESULTS: For the three-layer palatoplasty in both groups, there was a greater tendency for resolution of secretory otitis media in the early postoperative period, less time required for extrusion of the grommet tube, and a lower incidence of recurrent secretory otitis media. The incidence of postoperative velopharyngeal incompetence was greater with two-layer palatoplasty group. The incidence of palatal fistula was greater with three-layer palatoplasty. CONCLUSIONS:Palatal muscle reconstruction in cleft palatepatients confers better functional results regarding velopharyngeal competence and eustachian tube function. Although the overall incidence of postoperative palatal fistula is within the accepted range, the incidence of fistula is higher in the palatal muscle reconstruction subgroup. Future studies are required that include a larger number of patients.
Authors: Elizabeth McIlvaine; Ali Borzabadi-Farahani; Christianne J Lane; Stanley P Azen; Stephen L-K Yen Journal: Int J Pediatr Otorhinolaryngol Date: 2014-02-12 Impact factor: 1.675
Authors: Cuneyt M Alper; Joseph E Losee; James T Seroky; Ellen M Mandel; Beverly C Richert; William J Doyle Journal: Cleft Palate Craniofac J Date: 2016-09
Authors: Cuneyt M Alper; Joseph E Losee; Ellen M Mandel; James T Seroky; J Douglas Swarts; William J Doyle Journal: Int J Pediatr Otorhinolaryngol Date: 2012-01-09 Impact factor: 1.675