scholarly journals Book Review: Cleft Palate: Middle Ear Disease and Hearing Loss

1979 ◽  
Vol 72 (1) ◽  
pp. 82-82
Author(s):  
E H Gustavson
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 ◽  
...  

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.


2004 ◽  
Vol 41 (4) ◽  
pp. 364-367 ◽  
Author(s):  
Patrick Sheahan ◽  
Ian Miller ◽  
Michael J. Earley ◽  
Jerome N. Sheahan ◽  
Alexander W. Blayney

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.


1975 ◽  
Vol 40 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Fred H. Bess ◽  
H. Donell Lewis ◽  
David J. Cieliczka

Clinical acoustic impedance findings in a group of 40 children with cleft lip or palate and a group of 20 noncleft children are presented. The cleft subjects exhibited a high incidence of hearing loss and aural pathology. The data suggest that impedance measurements lend pertinent supportive information to routine pure-tone audiometric testing in the detection and management of middle-ear disease in the cleft-palate population.


Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  

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.


PEDIATRICS ◽  
1969 ◽  
Vol 44 (1) ◽  
pp. 35-42
Author(s):  
Jack L. Paradise ◽  
Charles D. Bluestone ◽  
Herman Felder

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.


2018 ◽  
Vol 45 (6) ◽  
pp. 1143-1151 ◽  
Author(s):  
Tulasi Kota Karanth ◽  
Kenneth R. Whittemore

1973 ◽  
Vol 82 (3) ◽  
pp. 290-296 ◽  
Author(s):  
Richard R. Gacek

Since the risk of sensorineural hearing loss from persistent chronic otitis media and mastoiditis is greater than the risk to loss of labyrinthine function from carefully performed surgery, it is felt that the best treatment for chronic suppurative middle ear disease in an only-hearing ear is surgical removal of disease. Between the years 1961 to 1970 14 cases of chronic otitis media and mastoiditis in only-hearing ears were treated surgically at the Massachusetts Eye and Ear Infirmary. Five cases presented with resistant foul otorrhea, while five patients presented with increasing hearing loss and four with vertigo. The patients with hearing loss and vertigo were subjected to surgery at the earliest possible date. Wide-field surgical exposure of the mastoid and middle ear spaces with thorough removal of diseased tissue was carried out. Particular attention to avoid injury to the labyrinth, either directly or indirectly, must be kept in mind and it is recommended that surgery in only-hearing ears be performed by only the most experienced and capable otologic surgeon. All 14 ears have remained dry after surgery. Hearing was significantly improved in ten cases, while two were unchanged and two were made worse, as regards the conductive loss only. In all 14 cases postoperative discrimination scores were normal, so that even those cases that did not achieve serviceable hearing levels from surgery were able to use amplification. The results in this series confirm the feeling that carefully performed and timed surgery is effective in controlling chronic suppurative disease, while preserving function in only-hearing ears.


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