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Did we get lost in the Seventies? Adenoidectomy for middle ear disease in cleft palate children: a systematic review.
  • +11
  • Cecilia Rosso,
  • Antonio Bulfamante,
  • Carlotta Pipolo,
  • Emanuela Fuccillo,
  • alberto maccari,
  • Paolo Lozza,
  • alberto scotti,
  • antonia pisani,
  • luca castellani,
  • giuseppe de donato,
  • Maria Chiara Tavilla,
  • Sara Portaleone,
  • Giovanni Felisati,
  • alberto maria saibene
Cecilia Rosso
University of Milan
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Antonio Bulfamante
Università degli studi di milano
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Carlotta Pipolo
Università degli Studi di Milano
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Emanuela Fuccillo
San Paolo Hospital - University of Milan
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alberto maccari
San Paolo Hospital - University of Milan
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Paolo Lozza
Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo
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alberto scotti
San Paolo Hospital - University of Milan
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antonia pisani
San Paolo Hospital - University of Milan
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luca castellani
San Paolo Hospital - University of Milan
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giuseppe de donato
San Paolo Hospital - University of Milan
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Maria Chiara Tavilla
San Paolo Hospital - University of Milan
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Sara Portaleone
Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo
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Giovanni Felisati
University Clinic Milano, Polo San Paolo
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alberto maria saibene
San Paolo Hospital - University of Milan
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Abstract

OBJECTIVES: Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group is scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at filling this knowledge gap by collecting the available evidence on this subject, to frame possible further areas of research and interventions. DESIGN: A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. RESULTS: Among 321 unique citations, 3 studies were deemed eligible (2 case series and a retrospective cohort study). The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution (this last result being not statistically significant). CONCLUSION: Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data is therefore available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.