The Management of Otitis Media with Early Routine Insertion of Grommets in Children with Cleft Palate—A Systematic Review

2009 ◽  
Vol 46 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Sirisha Ponduri ◽  
Rebecca Bradley ◽  
Pamela E. Ellis ◽  
Sara T. Brookes ◽  
Jonathan R. Sandy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Language Development ◽  
Cleft Palate ◽  
Cohort Studies ◽  
Outcome Measures ◽  
Case Series ◽  
Secondary Outcome ◽  
Speech And Language ◽  
Historical Cohort ◽  
Speech And Language Development

Objective: To determine whether early routine grommet insertion in children with cleft palate has a beneficial effect on hearing and speech and language development compared with conservative management. Design: Systematic review of randomized controlled trials, controlled clinical trials, case series, and prospective and historical cohort studies. Main Outcome Measures: The main outcome measure was the effect of early routine grommet placement on the degree of conductive hearing loss. Secondary outcome measures included differences in hearing level, possible side effects, speech and language development, and quality of life. Results: We identified 368 citations for review. From a review of the titles, 34 potentially relevant papers were selected. Of these, 18 studies met our inclusion criteria, including eight case series, six historical cohort studies, three prospective cohort studies, and one randomized trial. Most studies were either small or of poor quality or both. The results of the studies were contradictory, with some studies suggesting early placement of grommets was beneficial and others reporting there was no benefit. Conclusions: There is currently insufficient evidence on which to base the clinical practice of early routine grommet placement in children with cleft palate.

scholarly journals A Systematic Review of Parent Training for Children with Communication Disorders in Korea

2021 ◽  
Vol 26 (3) ◽  
pp. 727-741
Author(s):  
Youngmee Lee ◽  
Heesun Park ◽  
Youjin Lee
Keyword(s):  
Systematic Review ◽  
Language Development ◽  
Parent Training ◽  
Data Extraction ◽  
Communication Disorders ◽  
Training Intervention ◽  
Speech And Language ◽  
Positive Effects ◽  
Current Systematic Review ◽  
Speech And Language Development

Objectives: The purpose of this study was to review the research trends in regards to parent training and the speech and language development of children with communication disorders in Korea, to evaluate the effectiveness of parent training for improvement of children’s communication skills, and to provide evidence-based directions for parent training.Methods: A search of 4 databases, and manual searching resulted in the identification of 1,222 relevant articles in domestic journals. The 19 articles published from 2001 to 2020 in domestic journals were selected according to the Participants, Intervention, Comparison, and Outcomes (PICO) criteria. Three authors did article selection, data extraction, and quality assessment using the Risk of Bias for Nonrandomized studies (ROBANS).Results: First, the quality of selected articles was high overall. Second, very few studies have empirically examined the effectiveness of parent training intervention on the speech and language development of children with communication disorders. Third, most programs have been provided for mothers and no program focused on supporting fathers. Most programs focused on infants, toddlers, and preschoolers with communication disorders. Fourth, regarding studies on research type and method of data collection; most studies were conducted by experimental study. Lastly, areas of measurement involved participant interactions, development, parent perceptions, and parent experiences. The research studies reported positive effects of parent training intervention on the speech and language development of children with communication disorders.Conclusion: Based on these results, we discussed the limitations of identified studies and limitations of the current systematic review are discussed, as well as implications of the findings for research and practice for children with communication disorders regarding parent training intervention.

The Association Between Age at Palatoplasty and Speech and Language Outcomes in Children With Cleft Palate: An Observational Chart Review Study

2019 ◽  
Vol 57 (2) ◽  
pp. 148-160 ◽  
Author(s):  
Amber D. Shaffer ◽  
Matthew D. Ford ◽  
Joseph E. Losee ◽  
Jesse Goldstein ◽  
Bernard J. Costello ◽  
...  
Keyword(s):  
Language Development ◽  
Cleft Palate ◽  
Outcome Measures ◽  
Tertiary Care ◽  
Language Delays ◽  
Language Outcomes ◽  
Speech And Language ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
The Impact

Objective: To determine whether timing of palatoplasty (early, standard, or late) is associated with speech and language outcomes in children with cleft palate. Design: Retrospective case series. Setting: Tertiary care children’s hospital. Participants: Records from 733 children born between 2005 and 2015 and treated at the Cleft Craniofacial Clinic of a tertiary children’s hospital were retrospectively reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, syndromes, staged palatoplasty, and introduction to clinic after 12 months of age. Data from 232 children with cleft palate ± cleft lip were analyzed. Interventions: Palatoplasty. Main Outcome Measures: Speech/language delays and disorders at 20 months and 5 years of age based on formal hospital or community-based testing or screening evaluation in the Cleft Craniofacial Clinic; additional speech surgery. Results: Median age at palatoplasty was 12.6 months (range: 8.8-21.9 months). Age at palatoplasty was classified as early (<11 months, n = 28), standard (11-13 months, n = 158), or late (>13 months, n = 46). Late palatoplasty was associated with increased odds of speech/language delays and speech therapy at 20 months, and language delays at 5 years, compared with standard or early palatoplasty ( P < .05 for all comparisons). However, speech sound production disorders, velopharyngeal incompetence, tube replacement, and hearing loss were not significantly associated with age at palatoplasty. Conclusions: Late palatoplasty may be associated with short- and long-term delays in speech/language development. Future studies with standardized surgical technique/timing and outcome measures are required to more definitively describe the impact of age at palatoplasty on speech/language development.

Longitudinal Comparison of the Speech and Language Performance of United States-Born and Internationally Adopted Toddlers with Cleft Lip and Palate

2018 ◽  
Vol 55 (7) ◽  
pp. 941-953 ◽  
Author(s):  
Nancy J. Scherer ◽  
Shauna Baker ◽  
Ann Kaiser ◽  
Jennifer R. Frey
Keyword(s):  
United States ◽  
Language Development ◽  
Cleft Palate ◽  
Cleft Lip ◽  
The United States ◽  
Speech And Language ◽  
Time Points ◽  
Speech And Language Development ◽  
Age Range ◽  
Internationally Adopted

Objective: This study compares the early speech and language development of children with cleft palate with or without cleft lip who were adopted internationally with children born in the United States. Design: Prospective longitudinal description of early speech and language development between 18 and 36 months of age. Participants: This study compares four children (age range = 19 to 38 months) with cleft palate with or without cleft lip who were adopted internationally with four children (age range = 19 to 38 months) with cleft palate with or without cleft lip who were born in the United States, matched for age, gender, and cleft type across three time points over 10 to 12 months. Main Outcome Measures: Children's speech-language skills were analyzed using standardized tests, parent surveys, language samples, and single-word phonological assessments to determine differences between the groups. Results: The mean scores for the children in the internationally adopted group were lower than the group born in the United States at all three time points for expressive language and speech sound production measures. Examination of matched pairs demonstrated observable differences for two of the four pairs. No differences were observed in cognitive performance and receptive language measures. Conclusions: The results suggest a cumulative effect of later palate repair and/or a variety of health and environmental factors associated with their early circumstances that persist to age 3 years. Early intervention to address the trajectory of speech and language is warranted. Given the findings from this small pilot study, a larger study of the long-term speech and language development of children who are internationally adopted and have cleft palate with or without cleft lip is recommended.

The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate

2017 ◽  
Vol 157 (3) ◽  
pp. 504-514 ◽  
Author(s):  
Amber D. Shaffer ◽  
Matthew D. Ford ◽  
Sukgi S. Choi ◽  
Noel Jabbour
Keyword(s):  
Language Development ◽  
Cleft Palate ◽  
Speech And Language ◽  
Tympanostomy Tubes ◽  
Speech And Language Development ◽  
The Impact

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose 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 are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods 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 published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. 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. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, 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.

Three-Dimensional Printing in Cleft Care: A Systematic Review

2021 ◽  
pp. 105566562110131
Author(s):  
Farrukh R. Virani ◽  
Evan C. Chua ◽  
Mary Roz Timbang ◽  
Tsung-yen Hsieh ◽  
Craig W. Senders
Keyword(s):  
Systematic Review ◽  
3D Printing ◽  
Clinical Outcomes ◽  
Outcome Measures ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Secondary Outcome ◽  
Exclusion Criteria ◽  
3 Dimensional ◽  
Dimensional Printing

Objective: To determine the current applications of 3-dimensional (3D) printing in the care of patients with cleft lip and palate. We also reviewed 3D printing limitations, financial analysis, and future implications. Design: Retrospective systematic review. Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were used by 3 independent reviewers. Articles were identified from Cochrane library, Ovid Medline, and Embase. Search terms included 3D printing, 3 dimensional printing, additive manufacturing, rapid prototyping, cleft lip, and cleft palate. Exclusion criteria included articles not in English, animal studies, reviews without original data, oral presentations, abstracts, opinion pieces, and articles without relevance to 3D printing or cleft lip and palate. Main Outcome Measures: Primary outcome measure was the purpose of 3D printing in the care of patients with cleft lip and palate. Secondary outcome measures were cost analysis and clinical outcomes. Results: Eight-four articles were identified, and 39 met inclusion/exclusion criteria. Eleven studies used 3D printing models for nasoalveolar molding. Patient-specific implants were developed via 3D printing in 6 articles. Surgical planning was conducted via 3D printing in 8 studies. Eight articles utilized 3D printing for anatomic models/educational purposes. 3-Dimensional printed models were used for surgical simulation/training in 6 articles. Bioprinting was utilized in 4 studies. Secondary outcome of cost was addressed in 8 articles. Conclusion: 3-Dimensional printing for the care of patients with cleft lip and palate has several applications. Potential advantages of utilizing this technology are demonstrated; however, literature is largely descriptive in nature with few clinical outcome measures. Future direction should be aimed at standardized reporting to include clinical outcomes, cost, material, printing method, and results.

scholarly journals Implementation of patient-reported outcome measures and patient-reported experience measures in melanoma clinical quality registries: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040751
Author(s):  
Zachary Blood ◽  
Anh Tran ◽  
Lauren Caleo ◽  
Robyn Saw ◽  
Mbathio Dieng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Outcome Measures ◽  
Cutaneous Melanoma ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Secondary Outcome ◽  
Clinical Quality ◽  
Patient Reported ◽  
Eortc Qlq

ObjectivesTo identify patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in clinical quality registries, for people with cutaneous melanoma, to inform a new Australian Melanoma Clinical Outcomes Registry; and describe opportunities and challenges of routine PROM/PREM collection, especially in primary care.DesignSystematic review.Primary and secondary outcome measuresWhich PROMs and PREMs are used in clinical quality registries for people with cutaneous melanoma, how they are collected, frequency of collection, participant recruitment methods and funding models for each registry.Results1134 studies were identified from MEDLINE, PreMEDLINE, Embase, PsychInfo, Cochrane Database of Abstracts of Reviews of Effects databases and TUFTS Cost-Effectiveness Analysis Registry, alongside grey literature, from database inception to 5th February 2020. Following screening, 14 studies were included, identifying four relevant registries: Dutch Melanoma Registry, Adelphi Real-World Disease-Specific Programme (Melanoma), Patient-Reported Outcomes Following Initial treatment and Long-term Evaluation of Survivorship Registry, and Cancer Experience Registry. These used seven PROMs: EuroQol-5 Dimensions, Functional Assessment of Cancer-General (FACT-G) and FACT-Melanoma (FACT-M), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Cancer 30 (EORTC QLQ-C30), Fatigue Assessment Scale Hospital Anxiety and Depression Scale, Patient-Reported Outcome Measures Information System-29 and one PREM; EORTC QLQ-Information Module 26. PROMs/PREMs in registries were reported to improve transparency of care; facilitate clinical auditing for quality assessment; enable cost-effectiveness analyses and create large-scale research platforms. Challenges included resource burden for data entry and potential collection bias toward younger, more affluent respondents. Feedback from patients with melanoma highlighted the relevance of PROMs/PREMs in assessing patient outcomes and patient experiences.ConclusionsClinical registries indicate PROMs/PREMs for melanoma care can be incorporated and address important gaps, however cost and collection bias may limit generalisability.PROSPERO registration numberCRD42018086737.

scholarly journals Efficacy and safety of anti-epidermal growth factor receptor agents for the treatment of oesophageal cancer: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e046352
Author(s):  
Lijuan Zhang ◽  
Yanli Song ◽  
Nan Jiang ◽  
Yaqi Huang ◽  
Bo Dong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Growth Factor ◽  
Outcome Measures ◽  
Oesophageal Cancer ◽  
Meta Analysis ◽  
Growth Factor Receptor ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Efficacy And Safety ◽  
Positive Effects

ObjectivesDespite remarkable advances in the treatment of oesophageal cancer (OC), the role of antiepidermal growth factor receptor (anti-EGFR) agents in treating OC remains controversial. Herein, a systematic review and meta-analysis were conducted to elucidate the efficacy and safety of anti-EGFR agents in patients with OC.DesignMeta-analysis of randomised controlled trials (RCTs) identified by searching the PubMed, Embase, Web of Science, ClinicalTrials.gov, Cochrane Library, Chinese Biology Medicine, China National Knowledge Infrastructure and Wanfang Data Knowledge Service Platform databases from inception to December 2019. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.SettingRCTs from any country and healthcare setting.ParticipantsPatients with OC.InterventionsCombination therapy with anti-EGFR agents and conventional treatments versus conventional treatments alone in patients with OC.Primary and secondary outcome measuresOverall survival (OS) and progression-free survival (PFS) were primary outcome measures, and objective response rate (ORR), disease control rate (DCR) and treatment toxicities were secondary outcome measures.ResultsIn total, 25 RCTs comprising 3406 patients with OC were included. Overall, anti-EGFR treatment significantly improved the OS (HR: 0.81, 95% CI 0.74 to 0.89, p<0.00001), ORR (relative risk (RR): 1.33, 95% CI 1.16 to 1.52, p<0.0001) and DCR (RR: 1.22, 95% CI 1.11 to 1.34, p<0.0001) but not PFS (HR: 0.91, 95% CI 0.76 to 1.08, p=0.26). Anti-EGFR treatment was significantly associated with higher incidences of myelosuppression, diarrhoea, acne-like rash and hypomagnesaemia.ConclusionsOverall, anti-EGFR agents have positive effects on OS, the ORR and DCR in OC. However, considering the high incidence of adverse effects, such as myelosuppression, diarrhoea, acne-like rashes and hypomagnesaemia, careful monitoring of patients with OC is recommended during anti-EGFR treatment.Trial registration numberCRD42020169230.

Sign in / Sign up

Export Citation Format

Share Document