T & A in Patients with Cleft Palate and/or VPI

T & A in Patients with Cleft Palate and/or VPI is organized by American Cleft Palate-Craniofacial Association (ACPA).

Dates:
Original Seminar Date: September 29, 2020
On-Demand Release Date: September 30, 2020
On-Demand Expiration Date: March 31, 2022
Expiration Date: August 29, 2022 11:55 PM

Description:
The course is aimed to discuss performance of tonsillectomy and adenoidectomy (T & A) in patients with cleft palate (CP) and/or velopharyngeal insufficiency (VPI). Performance of T & A in patients with CP and/or VPI is a controversial issue that has been addressed by several reports in the related scientific literature. The adenoid contributes to velopharyngeal closure during speech by reducing the space of the velopharyngeal sphincter between the soft palate, lateral pharyngeal walls and posterior pharyngeal wall. In contrast, hypertrophied tonsils not only do not contribute to velopharyngeal closure but they can hinder palatal movement especially when the growth is in a superior direction.  

When velopharyngeal surgery is performed with the objective of correcting VPI, enlarged adenoid can force the surgeon to place a pharyngeal flap or a sphincter pharyngoplasty lower than planned (according to imaging procedures) decreasing the effectiveness for restoring velopharyngeal closure and increasing the risk of airway obstruction. Thus, in selected cases adenoidectomy is a prerequisite for successfully performing surgery for correcting VPI. Another issue is the timing: should the adenoidectomy be performed in the same surgical stage as a pharyngeal flap or a sphincter pharyngoplasty or before? Moreover, if the adenoidectomy is performed before then the time between both procedures becomes also an issue.

Seminar Objectives:
• Learners will be able to perform adequate reviews and judgements of papers in peer review high impact journals concerning the following topics: VPI, Velopharyngeal surgery, Pharyngeal flap, T & A.
• The learner will be able to understand the role of adenoid for velopharyngeal closure.
•The learner will be able to explain why hypertrophied tonsils can cause VPI .
• The learner will be able to have a rationale for deciding when to perform T & A in cases of VPI.

Additional details will be posted as soon as information is available.