Middle-ear effusion in children with cleft palate: congenital or acquired?

2022 ◽  
pp. 1-8
Author(s):  
F Kraus ◽  
R Hagen ◽  
W Shehata-Dieler
Keyword(s):  
Cleft Palate ◽  
Middle Ear ◽  
Middle Ear Effusion ◽  
Ear Effusion

Otitis Media, Cleft Palate, and Middle Ear Ventilation

1981 ◽  
Vol 89 (2) ◽  
pp. 288-293 ◽  
Author(s):  
William L. Meyerhoff ◽  
Donald A. Shea ◽  
Craig A. Foster
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Tympanostomy Tube ◽  
Middle Ear Effusion ◽  
Tympanostomy Tubes ◽  
Middle Ear Ventilation ◽  
Ear Effusion

Chinchillas with unilateral tympanostomy tubes in place underwent palate-clefting in an effort to determine the histologic and bacteriologic effects of using tympanostomy tubes in the treatment of otitis media. The tympanostomy tube appeared to almost totally eliminate the occurrence of middle ear effusion but had much less, if any, effect on eliminating the middle ear inflammation which occurs in the clefted chinchilla.

scholarly journals The effect of intervelar veloplasty under magnification (Sommerlad’s Technique) without tympanostomy on middle ear effusion in cleft palate patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Ali Hoghoughi ◽  
Tayebeh Kazemi ◽  
Ali Khojasteh ◽  
Raha Habibagahi ◽  
Zahra Kalkate ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Hearing Threshold ◽  
Surgical Techniques ◽  
Middle Ear Effusion ◽  
Tube Insertion ◽  
Brainstem Response ◽  
The Right ◽  
Ear Effusion

Abstract Objective Different surgical techniques and management approaches have been introduced to manage the cleft palate (CP) and its complications, such as otitis media with effusion (OME) and auditory problems. The optimal method, as well as the ideal time for palatoplasty and ventilation tube insertion, are the subject of controversy in the literature. We aimed to evaluate The Effect of Intervelar Veloplasty under Magnification (Sommerlad’s Technique) without Tympanostomy on Middle Ear Effusion in Cleft Palate Patients. Methods non-syndromic cleft palate patients from birth to 24 months who needed primary palatoplasty from April 2017 to 2019 were enrolled in this study. intravelar veloplasty (IVVP) surgery under magnification has been done by the same surgeon. Likewise, Otoscopy, Auditory Brainstem Response (ABR), and tympanometry were performed for all the patients before and six months after palatoplasty. Results Tympanograms were classified into two categories according to shape and middle ear pressure, and it was done in 42 children (84 ears). Type B curve was seen in 40 cases (80 ears) before surgery which reduced significantly (P < 0.005) to 12 cases in the left ear and 14 cases in the right ear after surgery. So, after surgery, 70 % of the tympanogram of left ears and 66.6 % of the tympanogram of Rt ears were in normal condition (type A tympanometry). ABR was done for 43 patients (86 ears) before surgery and six months after palatoplasty. Data were shown that 40 of the patients had mild to moderate hearing loss before surgery, which reduced significantly (P < 0.005) to 9 in the left ear and 11 in the right ear after palatoplasty. So, after surgery, 79 % of ABR of left ears and 73.8 % of ABR of right ears were in normal status (normal hearing threshold). Conclusions Intervelar veloplasty under magnification (Sommerlad’s technique) significantly improved the middle ear effusion without the need for tympanostomy tube insertion.

Evidence in Infants With Cleft Palate That Breast Milk Protects Against Otitis Media

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 853-860 ◽  
Author(s):  
Jack L. Paradise ◽  
Barbara A. Elster ◽  
Lingshi Tan
Keyword(s):  
Breast Milk ◽  
Cleft Palate ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Tube Placement ◽  
Middle Ear Effusion ◽  
Feeding Mode ◽  
Initial Development ◽  
Ear Effusion

Objective. Most infants with cleft palate suckle unproductively and require feeding by artificial means. Most also have unremitting otitis media accompanied by (usually) nonpurulent middle-ear effusion, a complication generally attributed to impaired eustachian tube ventilatory function. We observed two infants with cleft palate in whom one or both ears appeared effusionfree on more than one occasion, and who also were receiving or previously had received breast milk feedings. This prompted us to analyze the relation between middle-ear status and feeding mode in a large series of infants with cleft palate. Our objective was to determine whether in these infants the receipt of breast milk mitigated the otherwise virtually invariable development and continued presence of otitis media. Methods. We reviewed and analyzed data concerning both feeding mode and the presence or absence of middle-ear effusion in 315 infants with cleft palate, as recorded systematically in the course of prospective studies at our Cleft Palate-Craniofacial Center. Analysis was limited to periods preceding the infants' receipt of tympanostomy-tube placement or palate repair, or their second birthday, whichever occurred first. Results. Freedom from effusion in one or both ears was found at one or more visits in only seven (2.7%) of 261 infants fed cow's milk or soy formula exclusively, but in 17 (32%) of 54 infants fed breast milk exclusively or in part for varying periods (P &lt; .0001). In virtually all instances, the breast milk had been harvested by the mother and fed to the infant via an artificial feeder. Baseline clinical and sociodemographic characteristics and surveillance in the two groups of infants were comparable. Conclusions. Artificially fed breast milk provides variable protection against the development of otitis media in infants with cleft palate. This finding supports the likelihood of a similarly protective effect of breast milk in noncleft infants. The finding also suggests strongly that in infants with cleft palate, impaired eustachian tube function is not the only pathogenetic factor in the infants' initial development of middle-ear effusion.

Treatment of persistent middle ear effusion in cleft palate patients

2010 ◽  
Vol 74 (8) ◽  
pp. 874-877 ◽  
Author(s):  
C. Szabo ◽  
K. Langevin ◽  
S. Schoem ◽  
K. Mabry
Keyword(s):  
Cleft Palate ◽  
Middle Ear ◽  
Middle Ear Effusion ◽  
Ear Effusion

Management of Middle Ear Effusions in Infants with Cleft Palate

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 285-288 ◽  
Author(s):  
Jack L. Paradise
Keyword(s):  
Cleft Palate ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
Language Function ◽  
Middle Ear Effusion ◽  
Tube Insertion ◽  
Advantages And Disadvantages ◽  
Conductive Hearing ◽  
A Current ◽  
Ear Effusion

Middle ear effusion is now generally recognized as a virtually universal complication in infants with cleft palate. Such infants may therefore be assumed to experience conductive hearing loss of some degree or other throughout infancy. Hoping to prevent not only deficits in intellectual and language development, but also permanent otic and auditory handicaps, we have routinely treated such infants as early as practicable with myringotomy and tympanostomy tube insertion. Subsequently, we have repeated the operation whenever blockage or extrusion of the tubes resulted in recurrence of persistent effusion. In this manner we have been able to maintain most infants in satisfactory middle ear status most of the time. Otorrhea, however, has been a frequent complication. Preliminary findings suggest that infants managed according to this regimen may eventually develop better language function than those not receiving such management. A current study is designed to test the advantages and disadvantages that might result from deferring the initial routine myringotomy until somewhat later in infancy.

scholarly journals Importance of early ventilation tubes insertion in chronic otitis media with effusion in children with congenital cleft palate

2018 ◽  
Vol 75 (3) ◽  
pp. 253-259
Author(s):  
Vladan Subarevic ◽  
Nenad Arsovic ◽  
Radoje Simic ◽  
Katarina Stankovic
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Speech Development ◽  
Middle Ear Effusion ◽  
Ventilation Tubes ◽  
Congenital Cleft ◽  
Ear Effusion

Background/Aim. Otitis media with effusion (OME) is almost universal in children with cleft palate with an incidence of more than 90%, but the approach to managing this problem varies significantly among authors. The Eustachian tube dysfunction is the main factor that leads to the presence of the middle ear effusion. This is especially prominent in children with congenital cleft palate and explains the prolonged course of this process. The objective of this study was to determine the effectiveness of early ventilation tubes insertion in children with cleft palate at the time of palatoplasty by monitoring the course and duration of the disease as well as development of complications. Methods. In the prospective study with predefined regular follow-up intervals and parameters, the two groups of children were observed. The group one (E) included 45 children with congenital cleft palate who underwent the early insertion of ventilation tubes during palatoplasty, and the group two (C) had the same number of children with cleft palate who were treated conservatively on an as-needed basis. Assessment parameters were findings of otomicroscopy, tympanometry, play and pure tone audiometry. Each child was followed-up for 5 full years at total of nine follow-up examinations. Results. Result analysis showed that there were no statistically important differences between the two study groups in terms of the course and duration of the presence of the middle ear effusion, or in terms of complications and speech development. Conclusion. Based on the results obtained, we can conclude that there is no significant benefit in early ventilation tubes insertion in children with cleft palate, therefore our recommendation is watchful waiting and a conservative treatment on an as-needed basis, with the ventilation tubes insertion when a surgeon, based on his or her experience and individual findings considers it necessary.

EARLY TREATMENT OF THE UNIVERSAL OTITIS MEDIA OF INFANTS WITH CLEFT PALATE

PEDIATRICS ◽  
1974 ◽  
Vol 53 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Jack L. Paradise ◽  
Charles D. Bluestone
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Intellectual Development ◽  
Middle Ear Effusion ◽  
Suppurative Otitis Media ◽  
Tympanostomy Tubes ◽  
Palate Repair ◽  
Ear Effusion

In 138 infants with cleft palate, secretory or suppurative otitis media was a universal complication. Middle ear aeration was instituted by means of myringotomy, aspiration of middle ear liquid, and insertion of tympanostomy tubes, and this procedure was repeated whenever recurrence of middle ear effusion followed blockage or extrusion of the tubes. In infants with either complete or incomplete clefts of the palate, satisfactory middle ear status could usually be maintained. Otorrhea through tympanostomy tubes occurred frequently, but usually responded promptly to treatment. Palate repair resulted in sharp improvement in middle ear status. Early relief of middle ear effusion anti establishment and maintenance of middle ear aeration in infants with cleft palate may help maintain normal hearing acuity throughout infancy, with favorable implications for language and intellectual development, and may reduce the risk of permanent middle ear damage and hearing impairment. Further study is necessary to determine the long-term efficacy of this regimen.

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