Middle-ear disease in children with cleft palate

2018 ◽  
Vol 45 (6) ◽  
pp. 1143-1151 ◽  
Author(s):  
Tulasi Kota Karanth ◽  
Kenneth R. Whittemore
Keyword(s):  
Cleft Palate ◽  
Middle Ear ◽  
Middle Ear Disease

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.

THE UNIVERSALITY OF OTITIS MEDIA IN 50 INFANTS WITH CLEFT PALATE

PEDIATRICS ◽  
1969 ◽  
Vol 44 (1) ◽  
pp. 35-42
Author(s):  
Jack L. Paradise ◽  
Charles D. Bluestone ◽  
Herman Felder
Keyword(s):  
Adverse Effects ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Emotional Development ◽  
Well Being ◽  
Suppurative Otitis Media ◽  
Middle Ear Disease ◽  
And Function ◽  
Irreparable Damage

Bilateral secretory (serous) or suppurative otitis media was found without exception in 50 infants with cleft palate who were 20 months of age or younger. Middle ear disease probably develops in all cleft palate infants during the first few months of life, and appears to be best managed by myringotomy with insertion of plastic tubes. Unless drainage and aeration of the middle ear are accomplished, irreparable damage to middle ear structures may develop in some patients; and, in all of them, hearing impairment will probably persist throughout infancy or longer, with adverse effects on well-being and function and with serious implications for intellectual, speech, and emotional development. Further studies are required to assess the long-range effectiveness of surgical management.

Effect of Certain Head and Neck Tumors and Their Treatment on the Ventilatory Function of the Eustachian Tube and Hearing Loss

1983 ◽  
Vol 92 (6_suppl) ◽  
pp. 24-25
Author(s):  
E. N. Myers ◽  
Q. C. Beery ◽  
C. D. Bluestone ◽  
M. B. Möller ◽  
B. A. Sigler ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Animal Models ◽  
Cleft Palate ◽  
Head And Neck ◽  
Middle Ear ◽  
Clinical Condition ◽  
Ventilatory Function ◽  
Neck Tumors ◽  
Pathological Conditions ◽  
Middle Ear Disease

The management of patients with middle ear disease should be based on an understanding of the pathogenesis of the disease and its course. In this group of investigations, patients with pathological conditions such as cleft palate, which affects ET function, are studied. Animal models are then developed to simulate the clinical condition, thus providing a method of isolating the variables.

Incidence and outcome of middle ear disease in cleft lip and/or cleft palate

2003 ◽  
Vol 67 (7) ◽  
pp. 785-793 ◽  
Author(s):  
Patrick Sheahan ◽  
Ian Miller ◽  
Jerome N. Sheahan ◽  
Michael J. Earley ◽  
Alexander W. Blayney
Keyword(s):  
Cleft Palate ◽  
Middle Ear ◽  
Cleft Lip ◽  
Middle Ear Disease

Middle Ear Disease in Children with Congenital Velopharyngeal Insufficiency

2004 ◽  
Vol 41 (4) ◽  
pp. 364-367 ◽  
Author(s):  
Patrick Sheahan ◽  
Ian Miller ◽  
Michael J. Earley ◽  
Jerome N. Sheahan ◽  
Alexander W. Blayney
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Middle Ear ◽  
Medical Records ◽  
Velopharyngeal Insufficiency ◽  
Type I ◽  
Significant Difference ◽  
History Of ◽  
Ear Infections ◽  
Middle Ear Disease

Objective To examine the incidence and natural history of middle ear disease in children with congenital velopharyngeal insufficiency (VPI) without cleft palate. Setting and Subjects Children with congenital VPI attending the combined cleft clinic at a tertiary cleft center. The diagnosis of congenital VPI in all cases was confirmed be the observation of hypernasality, nasal air escape, or both by a speech and language therapist and the demonstration of incompetence of the velopharyngeal sphincter by means of nasoendoscopy or videofluoroscopy. Children with overt cleft palate or postsurgical VPI were excluded. Design The children's medical records were reviewed, and a questionnaire regarding history of ear problems was sent to all parents. Children were divided into those with Pruzansky type I VPI (showing bifid uvula, midline diastasis of soft palate, or submucous cleft of the hard palate) and Pruzansky type II VPI (no visible stigmata). Main Outcome Measures Incidence of reported ear problems, ear infections, hearing loss, and surgical intervention for middle ear disease in the whole group and in each of the subgroups. Results Seventy-one parents returned completed questionnaires. The overall incidence of middle ear disease was 63%, with 28% reported to have below-normal hearing. There was no significant difference between children with Pruzansky types I and II VPI with respect to incidence of otopathology or hearing loss. Conclusions Irrespective of the presence of any visible palatal abnormalities, children with congenital VPI showed a substantial incidence of otopathology and should thus be closely monitored.

Detection of Middle Ear Disease in Cleft-Palate Patients

1979 ◽  
Vol 87 (6) ◽  
pp. 876-879 ◽  
Author(s):  
David Hunter ◽  
Robert J. Keim
Keyword(s):  
Cleft Palate ◽  
Prospective Study ◽  
Middle Ear ◽  
Advanced Stage ◽  
Stage Of Disease ◽  
Primary Physician ◽  
Middle Ear Disease ◽  
A Prospective Study

A prospective study of 17 cleft-palate patients under the age of 37 months was performed. The otoscopic findings, as reported by the primary physician and otolaryngologist, were compared with the results of tympanometry. Preoperatively, all tympanograms were abnormal. Ears with an As pattern were not described as abnormal by any physician, and postoperatively, these ears all progressed to a more advanced stage of disease.

Subannular Tubes in Children With Cleft Palate

2021 ◽  
pp. 105566562199017
Author(s):  
Sónia Pires Martins ◽  
Pedro Lopes Alexandre ◽  
Margarida Santos ◽  
Carla Pinto Moura
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Tube Obstruction ◽  
Tube Extrusion ◽  
Tertiary Center ◽  
Retraction Pockets ◽  
Middle Ear Disease

Objective: To investigate subannular tube (SAT) placement as an alternative treatment of chronic middle ear disease in children with cleft palate. Design: Retrospective cohort study. Participants: All children with cleft palate with intractable otitis media with effusion and/or with tympanic membrane retraction, operated for insertion of 1 or more sets of transtympanic tubes followed by SAT in a tertiary center. Main Outcome Measures: Audiological outcomes, average duration of tubes, and postoperative complications were analyzed. Results: This study included 21 children with cleft palate, aged 3 to 14 years. A total of 38 ears was evaluated. The median time of follow-up was 42 months. During follow-up, 69.2% of the patients had no complications. Observed complications were otorrhea (13.5%) and tube obstruction (7.7%). In 7.9% of the cases, otitis media with effusion relapsed after tube extrusion. By the end of the study, 76.3% of the tubes remained in situ and 68.4% of the tympanic membranes had the SAT in place and had no significant alterations. The mean duration of SATs was 16 months, which was significantly superior to transtympanic tube duration. A significant sustained improvement in the hearing of children with SATs was observed. Conclusion: Subannular tube insertion results in hearing improvement to normal range and tympanic retraction pockets reversion in children with cleft palate with persistent otitis media with effusion and tympanic retraction/atelectasis. This surgery appears to be safe and provides long-term efficient middle ear aeration. Strict postoperative follow-up is crucial for the success of the treatment.

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