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.

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.

scholarly journals Postoperative results of ventilation tube insertion: a retrospective multicenter study for suggestion of grading system of otitis media with effusion

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan Il Song ◽  
Byung Chul Kang ◽  
Chol Ho Shin ◽  
Yun Suk An ◽  
Tae Su Kim ◽  
...  
Keyword(s):  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Grading System ◽  
Air Bubbles ◽  
Tympanic Cavity ◽  
Ventilation Tube ◽  
Middle Ear Effusion ◽  
Tube Insertion ◽  
Postoperative Results ◽  
Ear Effusion

Abstract Background In otitis media with effusion (OME), it is important to know when to surgically intervene and when careful monitoring is more appropriate. This study aimed to visualize and classify the clinical manifestations of OME and the correlation between the new grading system and postoperative results after ventilation tube insertion (VTI). Methods We classified the collective 1,012 ears from 506 patients into six groups: grade 0 (no effusion), grade I (scant effusion, but abnormal), grade II (effusion less than half of the tympanic cavity), grade III (effusion over half of the tympanic cavity, with air bubbles), grade IV (complete effusion), and grade V (retracted tympanic membrane or hemotympanum without air bubbles). Results The mean age at VTI was 5.2 (±2.9) years and mean duration between diagnosis and operation was 4.1 (±1.8) months. Between the grades, the nature of the middle ear effusion was also significantly different (p < 0.001). The duration of ventilation tube retention after VTI was significantly different when compared between two groups: grade I-IV and grade V (p = 0.019). Our results showed that the recurrence rate, as well as rate of revision VTI, increased as the grade increased (p < 0.001). Conclusions The new grading system of OME using endoscopic otoscope evaluation had a significant correlation with the age at VTI, the nature of middle ear effusion, the recurrence rate of OME, and the rate of revision VTI.

scholarly journals Tympanostomy Tube Complication in Otitis Media with Effusion

2020 ◽  
Vol 15 (2) ◽  
pp. 58-61
Author(s):  
Ghassan Hassan Rahim
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Tympanostomy Tube ◽  
Middle Ear Effusion ◽  
Tube Insertion ◽  
Patients Âgés ◽  
Acquired Hearing Loss ◽  
Ear Effusion

Background: Otitis media with effusion is characterized by accumulation of fluid in the middle ear in absence of acute inflammation and  it is the most common cause of  acquired hearing loss in children, and may  negatively affect language development failure of medical treatment of middle ear effusion frequently require myringotomy and tympanostomy tube insertion. Objectives: To determine tympanostomy tube complications of tube in children with chronic otitis media with effusion who were treated with Shah Grommet tube insertion. Methods: The Medical records of 162 ears of 87 children (52 male and 35 female) were reviewed respectively, the patients ages were between 3 to 16 years old (mean age =8.11 years), patient were followed for 6-66 months (mean 23.3) after tympanostomy tube insertion. Tube extrusion time was also reviewed in all patients, and the indication for surgery was chronic middle ear effusion. Results: Otorrhea accured in nine ears (5.6%), granulation tissue was seen in 2 ears (1.2%), myringosclerosis in (34.6%) persistent perfor-ation (5.6%), atrophy (23.5%) retraction (16.7%) and medial displacement 1.2% the average extrusion time was 8.5 month ( ± 4.6). Conclusions: complications of tympanostomy tube insertion are common and the most common are otorrhea myringosclerosis, atrophy but they are generally insignificant consequently in majority of these complications there is no need for management.

To Tube or Not to Tube: That Continues to Be the Question

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 332-332
Author(s):  
DAVID W. TEELE ◽  
BERNARD ROSNER ◽  
JEROME O. KLEIN
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Middle Ear Effusion ◽  
Speech And Language ◽  
Clinically Significant ◽  
Ear Effusion

In Reply.— We appreciate Chamberlin's thoughtful comments about the associations between otitis media with effusion and development of speech and language and his concern about results that are statistically significant but may not be "clinically significant." We share his view that measurements of the sequelae of disease should include those that are meaningful to the child. We reported results of tests of speech and language that indicated that children who had spent many days with middle ear effusion during the first years of life scored significantly lower than did children who had not spent such time.

Efficacy of medical treatment as an adjunct to surgery in the treatment of secretory otitis media

1986 ◽  
Vol 100 (12) ◽  
pp. 1347-1350 ◽  
Author(s):  
T. H. J. Lesser ◽  
M. I. Clayton ◽  
D. Skinner
Keyword(s):  
Medical Treatment ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Randomised Trial ◽  
Control Group ◽  
Middle Ear Effusion ◽  
Secretory Otitis Media ◽  
Ear Effusion

AbstractIn a pilot controlled randomised trial of 38 children who had bilateral secretory otitis media, with effusion demonstrated at operation, we compared the efficacy of a six-week course of an oral decongestant—antihistamine combination and a mucolytic preparation with a control group in preventing the presence of middle-ear effusion six weeks after myringotomy and adenoidectomy. The mucolytic preparation decreased the presence of middle-ear effusion when compared to the decongestant-antihistamine combination and the control group (p=0.06).

scholarly journals Experimental Otitis Media With Effusion Induced by Middle Ear Effusion

1992 ◽  
Vol 102 (9) ◽  
pp. 1037???1042 ◽  
Author(s):  
Junko Nakata ◽  
Masashi Suzuki ◽  
Hideyuki Kawauchi ◽  
Goro Mogi
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Middle Ear Effusion ◽  
Ear Effusion

Experimental Otitis Media with Effusion following Middle Ear Inoculation of Nonviable H Influenzae

1984 ◽  
Vol 93 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Thomas F. DeMaria ◽  
David J. Lim ◽  
Bruce R. Briggs ◽  
Nobuhiro Okazaki
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Animal Experiment ◽  
Otitis Media With Effusion ◽  
Type B ◽  
Negative Bacterium ◽  
Middle Ear Effusion ◽  
Sterile Saline ◽  
Inflammatory Changes ◽  
Ear Effusion

In order to test the hypothesis that nonviable bacteria can induce middle ear inflammation leading to persistent middle ear effusion (MEE), we conducted an animal experiment using formalin-killed Hemophilus influenzae, the bacterium reported to be the most common pathogen isolated from chronic MEEs. Over 70% of the chinchillas injected with formalin-killed H influenzae type b or a nontypeable isolate developed sterile, straw-colored serous MEEs, and exhibited histological evidence of extensive inflammatory changes of the middle ear mucosal connective tissue and epithelium. Control animals injected with pyrogen-free sterile saline did not exhibit any inflammatory changes or effusions in the middle ears. Our data suggest that endotoxin on the surface of H influenzae, a gram-negative bacterium, may be responsible for the induction of the otitis media with effusion. It is suggested that endotoxin (even when the organisms are no longer viable) may be responsible for the production of serous MEE and inflammatory changes in the middle ear.

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.

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