S Brosch1, L Nunner2, S Haase3, G Schlömer3, R Reiter2, W Angerstein4, T K Hoffmann5. 1. Sektion Phoniatrie und Pädaudiologie, Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland. sibylle.brosch@uniklinik-ulm.de. 2. Sektion Phoniatrie und Pädaudiologie, Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland. 3. Mund‑, Kiefer- und Gesichtschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland. 4. Phoniatrie und Pädaudiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland. 5. Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Ulm, Deutschland.
Abstract
BACKGROUND: A submucous cleft palate and a congenitally short velum are diagnosed rather late, because symptoms are often mild. OBJECTIVES: The pre- and postoperative clinical symptoms for both conditions are presented. MATERIALS AND METHODS: The data of 180 patients with a submucous cleft palate (161) or congenitally short velum (19) were retrospective analyzed. In 23.3%, a syndromic association was found. RESULTS: Clinical findings for both conditions included middle ear problems, hypernasal speech, nasal penetration, the absence of the posterior nasal spine of the hard palate and/or a bifid uvula with a zona pellucida. The average age at diagnosis was 4.2 years in submucous clefts and 5.7 years in children with a congenitally short velum. Surgical palatoplasty with fusion of soft palate muscles and/or elongation of the soft palate was performed in 83.9% of the children, aiming to achieve sufficient velopharyngeal closure (VPC) with a significant decrease of symptoms and, hence, better conditions for speech therapy interventions. The overall success rate of the VPC was 63.7% with improvement in up to 2 of the 3 clinical symptoms (hypernasal speech, nasal penetration, middle ear problems). Hypernasal speech was more common (in 89.5%) in children with a congenitally short velum before surgery and in 81.3% 8 weeks after surgery; however, prior to surgery they had a short soft palate. CONCLUSION: Surgical intervention was particularly effective in children younger than 5 years. Syndromic diseases are disproportionately associated with soft palate defects.
BACKGROUND: A submucous cleft palate and a congenitally short velum are diagnosed rather late, because symptoms are often mild. OBJECTIVES: The pre- and postoperative clinical symptoms for both conditions are presented. MATERIALS AND METHODS: The data of 180 patients with a submucous cleft palate (161) or congenitally short velum (19) were retrospective analyzed. In 23.3%, a syndromic association was found. RESULTS: Clinical findings for both conditions included middle ear problems, hypernasal speech, nasal penetration, the absence of the posterior nasal spine of the hard palate and/or a bifid uvula with a zona pellucida. The average age at diagnosis was 4.2 years in submucous clefts and 5.7 years in children with a congenitally short velum. Surgical palatoplasty with fusion of soft palate muscles and/or elongation of the soft palate was performed in 83.9% of the children, aiming to achieve sufficient velopharyngeal closure (VPC) with a significant decrease of symptoms and, hence, better conditions for speech therapy interventions. The overall success rate of the VPC was 63.7% with improvement in up to 2 of the 3 clinical symptoms (hypernasal speech, nasal penetration, middle ear problems). Hypernasal speech was more common (in 89.5%) in children with a congenitally short velum before surgery and in 81.3% 8 weeks after surgery; however, prior to surgery they had a short soft palate. CONCLUSION: Surgical intervention was particularly effective in children younger than 5 years. Syndromic diseases are disproportionately associated with soft palate defects.
Authors: R Schönweiler; J A Lisson; B Schönweiler; A Eckardt; M Ptok; J Tränkmann; J E Hausamen Journal: Int J Pediatr Otorhinolaryngol Date: 1999-11-05 Impact factor: 1.675
Authors: Jordan W Swanson; Brianne T Mitchell; Marilyn Cohen; Cynthia Solot; Oksana Jackson; David Low; Scott P Bartlett; Jesse A Taylor Journal: Ann Plast Surg Date: 2017-08 Impact factor: 1.539
Authors: Kim M Ha; Heather Cleland; Andrew Greensmith; David Chong; Kirstie Macgill; Andrea Verhoeven; John M Hutson Journal: J Craniofac Surg Date: 2013-05 Impact factor: 1.046
Authors: B J A Smarius; C H A L Guillaume; J Slegers; A B Mink van der Molen; C C Breugem Journal: Clin Oral Investig Date: 2021-02-01 Impact factor: 3.606