Myringostomy for Middle Ear Effusions

1976 ◽  
Vol 85 (2_suppl) ◽  
pp. 263-267 ◽  
Author(s):  
Herbert G. Birck ◽  
Joseph J. Mravec
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Total Population ◽  
Primary Treatment ◽  
Common Complication ◽  
Tube Insertion ◽  
Tympanic Membrane Perforations ◽  
Tympanostomy Tubes ◽  
Serous Otitis Media

From 1972 to 1974, 736 children had tympanostomy tubes inserted for chronic serous otitis media resistant to medical therapy. The total number of ears involved was 2,237. The cleft palate patients constituted 8.8% of the total and had 15.4% of all procedures. Patients with allergy comprised 19% of the total population and had a higher incidence of otitis media following tube insertion. Adenoidectomy was performed in 44% of all patients and 35* of these required further tube insertions, suggesting that adenoidectomy in combination with tube insertion is not necessarily the primary treatment of choice. Children under six made up 78.5% of the total. The most common complication, a draining ear with an incidence of 15.1% was treated successfully with aqueous Merthiolate® irrigations. There were 14 tympanic membrane perforations.

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.

Prophylactic treatment after ventilation tube insertion: Comparison of various methods

1998 ◽  
Vol 119 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Avishay Golz ◽  
Tamar Ghersin ◽  
Henry Zvi Joachims ◽  
S. Thomas Westerman ◽  
Liane M. Gilbert ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Otitis Media ◽  
Prophylactic Treatment ◽  
Common Complication ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Common Diseases ◽  
Tympanostomy Tubes ◽  
Head Neck

Otitis media is recognized as one of the most common diseases of childhood. Insertion of tympanostomy tubes for the treatment of otitis media is the most frequently performed otologic operation, and postoperative otorrhea is its most common complication. Many authors have suggested various reasons for posttympanostomy otorrhea, and many different prophylactic treatments were proposed in recent years to prevent this bothersome and frustrating complication. This retrospective study was designed to investigate and compare the efficacy of various prophylactic treatments and to define the most effective method of reducing the rate of postoperative otorrhea. (Otolaryngol Head Neck Surg 1998;119:117–20.)

scholarly journals Middle Ear Ventilation Tube in Patients with Cleft Palate at King Abdulaziz University Hospital

2017 ◽  
Vol 24 (2) ◽  
pp. 290-2
Author(s):  
Talal A. AlKhatib ◽  
Yasir S. Jamal ◽  
Abdulaziz H. Alghamdi ◽  
Bhaa M. Simbawa ◽  
Yahya H. Ghunaim ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Medical Records ◽  
Otitis Media With Effusion ◽  
University Hospital ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Middle Ear Ventilation ◽  
King Abdulaziz University

This study aims to determine the number of patients with cleft palate requiring treatment for otitis media with effusion. Speech and hearing assessments were also considered. We conducted a retrospective study from January, 2005 through December, 2012 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, on otitis media with effusion in patients with cleft palate. We reviewed patients’ medical records to determine the number requiring treatment for otitis media with effusion, the timing of middle ear ventilation tube insertion, the number of tubes to be inserted, and the type of tube to be used. Data were collected from the patients’ medical records. Ethical approval was obtained by the university’s ethical committee. A total of 101 patients were diagnosed with cleft palate spectrum. Among them, we found that only 12 patients had a hearing assessment and tympanograms performed followed by middle ear ventilation tube insertion. This may indicate the need for more involvement of the otolaryngologists in the multidisciplinary clinical teams for evaluating cleft palate patients.

Tympanic Membrane Perforations and Tympanostomy Tubes

1994 ◽  
Vol 103 (5_suppl) ◽  
pp. 27-30 ◽  
Author(s):  
Sam Levine ◽  
Kathleen Daly ◽  
G. Scott Giebink
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforations ◽  
Tympanostomy Tubes ◽  
Preoperative Factor ◽  
Middle Ear Disease

Tympanoplasty and tympanostomy tubes were developed at the same time and have dramatically changed the treatment of chronic middle ear disease. One hundred forty-nine children who had tubes inserted between ages 6 months and 8 years for chronic otitis media with effusion have been prospectively followed up for an average of 4 years. Fourteen percent developed tympanic membrane perforations. No preoperative factor completely predicted the development of perforation. a majority of the perforations closed spontaneously. Three ears had noncontiguous observations of perforations during follow-up. The implications of these findings are discussed with respect to tympanoplasty.

Results after Treatment of Otitis Media with Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 308-311 ◽  
Author(s):  
G. Muenker
Keyword(s):  
Inner Ear ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Bone Conduction ◽  
Tube Insertion ◽  
Tympanostomy Tubes ◽  
Ear Infections ◽  
Inner Ear Damage

Otitis media with effusion will be observed in every fifth child admitted for adenoid surgery; in children with cleft palates the incidence is 50%. With adenoidectomy alone, normal hearing can be restored in 50% and improved in further 25% of the patients. Over a 12-year period 1,683 patients with otitis media with effusion were treated with adenoidectomy and with insertion of tympanostomy tubes in those cases where adenoidectomy proved to be ineffective. Since the tubes only substitute tubal function, recurrences have to be expected in more than 30% after spontaneous extrusion of the tubes. Of all recurrences, 93% occur within two years after tube insertion. With thorough follow-up and repeated insertion of tubes, deterioration of the middle ear can be avoided and hearing kept normal. Impaired bone conduction does not reflect inner ear damage, but will improve with ventilation of the middle ear. Infections occur in 15% (5% postoperatively, 10% later); persistent perforations in 2.5% and cholesteatoma in 0.9%.

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.

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.

Serous Otitis Media

1973 ◽  
Vol 82 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Robert W. Veltri ◽  
Philip M. Sprinkle
Keyword(s):  
Otitis Media ◽  
Eustachian Tube ◽  
Middle Ear ◽  
Secretory Iga ◽  
Secretory Cells ◽  
Sterile Condition ◽  
Local Synthesis ◽  
Serous Otitis Media ◽  
Inflammatory Insult ◽  
Partial Vacuum

The middle ear fluids of seven patients with bilateral, and five patients with unilateral serous otitis media (SOM), were demonstrated to be microbiologically sterile when assessed for the presence of bacteria, mycoplasma, viruses, and fungi. The concentrations of immunoglobulins G, M, A, D, and lysozyme (muramidase) were determined in the serum and middle ear fluids. Lysozyme levels of middle ear aspirates were found to be elevated in SOM patients. The elevated levels of lysozyme in combination with the antibody-containing classes of immunoglobulins may explain the microbiologically sterile condition of the middle ear fluids of SOM patients. Also, the elevated lysozyme concentrations in middle ear fluids may indicate the previous presence of neutrophils and hence a previous inflammatory insult. The increased levels of IgA demonstrated in middle ear fluids may indicate local synthesis of secretory IgA by secretory cells of Eustachian tube and middle ear. The closed Eustachian tube, partial vacuum conditions and absence of a portal of exit for accumulated serous fluids are offered as a possible explanation for SOM.

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.

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