Repaired Cleft Palate and Ventilation Tubes and Their Associations with Cholesteatoma in Children and Adults

2009 ◽  
Vol 46 (6) ◽  
pp. 598-602 ◽  
Author(s):  
Rudolf Reiter ◽  
Stephan Haase ◽  
Sibylle Brosch
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Clinical Examination ◽  
Demographic Data ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Bilateral Hearing Loss ◽  
Submucous Cleft Palate ◽  
Ventilation Tubes

Objective: To determine the influence of ventilation tubes (VTs) on the formation of cholesteatoma and hearing in operated cleft palate patients with chronic ear problems. Design: Retrospective 72-month follow-up of 116 operated cleft palate patients. Patients and Interventions: Demographic data, clinical examination, and hearing were evaluated. The patients were divided according to age and type of cleft and subdivided in a subgroup with (VT+) or without ventilation tube (VT−). Main Outcome Measures: The effect of ventilation tubes (VT) on the incidence of cholesteatoma formation and degree of hearing loss in operated cleft palate patients with chronic ear problems. Results: The overall incidence of cholesteatoma was 15.5% (VT+, 14.0%; VT−, 16.7%; not significant). Bilateral hearing loss of >20 dB remained in 14.0% of the VT+ patients and in 22.7% of the VT− patients (p < .05). Submucous cleft palate (SM CP) adults (n  =  15) developed high rates of cholesteatoma and hearing loss of >20 dB (both 26.7%). Conclusions: Tube insertion had no influence on the development of cholesteatoma. Adults with submucous cleft palate especially require periodic otologic evaluation because they have Eustachian tube–related otologic disease and hearing loss at a higher rate than expected.

Comparison of the Hearing Histories of Children with and without Cleft Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Patricia A. Broen ◽  
Karlind T. Moller ◽  
Jane Carlstrom ◽  
Shirley S. Doyle ◽  
Monica Devers ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Medical Records ◽  
Otitis Media With Effusion ◽  
Hearing Screening ◽  
Tube Placement ◽  
Ventilation Tube ◽  
Ventilation Tubes

Aggressive otologic management has been recommended for children with cleft palate because of the almost universal occurrence of otitis media with effusion (OME) in these children and the association of OME with hearing loss and possible language, cognitive, and academic delays. In this study, 28 children with cleft palate and 29 noncleft children were seen at 3-month intervals from 9 to 30 months to compare otologic treatment and management. Hearing and middle ear function were tested at each session; information on ventilation tube placement was obtained from medical records. Ventilation tubes were placed earlier and more often in children with cleft palate, but children with cleft palates failed the hearing screening more often. The correlation between age at first tube placement and frequency of hearing screening failures was significant for the children with cleft palate, indicating that the later tubes were first placed, the poorer the child's hearing.

Myringotomy and ventilation tube insertion: a ten-year follow-up

1997 ◽  
Vol 111 (3) ◽  
pp. 257-261 ◽  
Author(s):  
D. N. Riley ◽  
S. Herberger ◽  
G. McBride ◽  
K. Law
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media With Effusion ◽  
Recurrent Infection ◽  
Tympanic Membrane Perforation ◽  
Significant Loss ◽  
Type I ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Ventilation Tubes

AbstractEighty children who had myringotomy performed for otitis media with effusion in 1984 were reviewed in 1994. This had involved surgery on 158 ears. Three aspects of ear condition were studied: hearing loss, tympanic membrane perforation, and tympanosclerosis. Hearing losses were present in 13 ears (8.2 per cent), involving 10 children (12.5 per cent), although losses were under 20 dB in seven of these ears (five patients).Of the six ears with losses more than 20 dB (3.8 per cent), in five patients bilateral losses of 30 dB were due to a recurrence of effusions, a large dry posterior perforation was the cause of a 30 dB loss, an infected anterior perforation had caused a 30 dB loss, an ear which had a cholesteatoma, and had a mastoidectomy and ossiculoplasty in 1987, had a 30–40 dB loss, and one ear which had a Type I tympanoplasty in 1994 had a 50 dB loss. Therefore in only three ears (1.9 per cent) could hearing loss be associated directly with myringotomy and ventilation tube insertion.Perforations had persisted unilaterally in seven patients, three having had tympanoplasties. Of the remaining perforated tympanic membranes, two were free of symptoms, one had only a slight hearing loss, and one had a more significant loss with recurrent infection.Tympanosclerosis was only found in those ears which had ventilation tubes inserted (and not those which had myringotomy only), occurring in 48 ears (31 per cent, or 39 per cent of those which had a ventilation tube inserted).There was no link between tympanosclerosis and hearing loss. The site of tympanosclerosis was not restricted to the site of myringotomy, and in many cases was present only in other areas of the tympanic membrane. There was a tendency for more extensive tympanosclerosis to occur in those ears which had more ventilation tube insertions. The risk of perforation in particular lends support to a policy of ‘watchful waiting’.

Otitis Media with Effusion and Hearing Loss in Chinese Children with Cleft Lip and Palate

2011 ◽  
Vol 48 (6) ◽  
pp. 684-689 ◽  
Author(s):  
Wendy M.Y. Kwan ◽  
Victor J. Abdullah ◽  
Kelvin Liu ◽  
C. Andrew Van Hasselt ◽  
Michael C.F. Tong
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Otitis Media ◽  
Cleft Lip ◽  
Otitis Media With Effusion ◽  
Hearing Level ◽  
Care Hospital ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Moderate Hearing Loss

Objective To determine the incidence of otitis media with effusion and the associated hearing loss, the rate of ventilation tube insertion, and complications of ventilation tube insertion in Chinese cleft palate patients. Design Retrospective review in a tertiary care hospital in Hong Kong. Patients A total of 104 consecutive patients with cleft lip and/or cleft palate who were born between January 1996 and January 2006. Results The incidence of otitis media with effusion in Chinese cleft palate patients for the first 2 years after birth was 76.1%. Of these patients, 16.9% had otitis media with effusion associated with a moderate hearing loss (40 decibels hearing level [dBHL]). Approximately half (53.2%) of our patients had ventilation tube insertion. Complications including retraction, tympanosclerosis, and perforation of the tympanic membrane were found in 15.7% of all ears with otitis media with effusion and ventilation tube insertion. Conclusions The high incidence of otitis media with effusion in cleft palate infants found in this study is consistent with that reported in the Western literature. A small but significant proportion of otitis media with effusion was associated with moderate hearing loss that truly required surgical treatment. Cleft palate children are much more likely to develop otitis media with effusion than normal children, and they develop the condition at an earlier age. A protocol for the treatment of otitis media with effusion in cleft palate patients and further prospective studies are warranted.

Phonological Profile of Patients With Velopharyngeal Dysfunction and Palatal Anomalies

2021 ◽  
pp. 1-15
Author(s):  
Ariela Nachmani ◽  
Muhamed Masalha ◽  
Firas Kassem
Keyword(s):  
Cleft Palate ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Age Groups ◽  
Phonological Process ◽  
Phonological Processes ◽  
Process Error ◽  
Submucous Cleft Palate ◽  
Different Types

Purpose This purpose of this study was to assess the frequency and types of phonological process errors in patients with velopharyngeal dysfunction (VPD) and the different types of palatal anomalies. Method A total of 808 nonsyndromic patients with VPD, who underwent follow-up at the Center for Cleft Palate and Craniofacial Anomalies, from 2000 to 2016 were included. Patients were stratified into four age groups and five subphenotypes of palatal anomalies: cleft lip and palate (CLP), cleft palate (CP), submucous cleft palate (SMCP), occult submucous cleft palate (OSMCP), and non-CP. Phonological processes were compared among groups. Results The 808 patients ranged in age from 3 to 29 years, and 439 (54.3%) were male. Overall, 262/808 patients (32.4%) had phonological process errors; 80 (59.7%) ages 3–4 years, 98 (40, 0%) ages 4.1–6 years, 48 (24.7%) 6.1–9 years, and 36 (15.3%) 9.1–29 years. Devoicing was the most prevalent phonological process error, found in 97 patients (12%), followed by cluster reduction in 82 (10.1%), fronting in 66 (8.2%), stopping in 45 (5.6%), final consonant deletion in 43 (5.3%), backing in 30 (3.7%), and syllable deletion and onset deletion in 13 (1.6%) patients. No differences were found in devoicing errors between palatal anomalies, even with increasing age. Phonological processes were found in 61/138 (44.20%) with CP, 46/118 (38.1%) with SMCP, 61/188 (32.4%) with non-CP, 70/268 (26.1%) with OSMCP, and 25/96 (26.2%) with CLP. Phonological process errors were most frequent with CP and least with OSMCP ( p = .001). Conclusions Phonological process errors in nonsyndromic VPD patients remained relatively high in all age groups up to adulthood, regardless of the type of palatal anomaly. Our findings regarding the phonological skills of patients with palatal anomalies can help clarify the etiology of speech and sound disorders in VPD patients, and contribute to general phonetic and phonological studies.

Complications of long-term ventilation tubes

2013 ◽  
Vol 127 (5) ◽  
pp. 509-510 ◽  
Author(s):  
H Mohammed ◽  
P Martinez-Devesa
Keyword(s):  
Ventilation Tube ◽  
Material Degradation ◽  
Long Term Follow Up ◽  
Ventilation Tubes ◽  
Chronic Inflammatory Reaction ◽  
Materials Used ◽  
Long Term Ventilation

AbstractObjective:To demonstrate that ventilation tubes can remain in situ much longer than expected, and that the materials used in the manufacturing of these tubes can degrade and cause complications. Long-term follow up and replacement of the tube is recommended.Method:Case report and review of the literature concerning the use of long-term ventilation tubes.Results:In the case reported, the ventilation tube was in place for 19 years, which resulted in chronic ear discharge. When it was removed, it was noted that the tube itself had degraded and had caused a chronic inflammatory reaction.Conclusion:We recommend that the long-term use of ventilation tubes is followed up and that the tube is replaced before material degradation takes place.

A Critical Appraisal of Ventilation Tube Insertion in Children With Cleft Palate—Reply

2015 ◽  
Vol 141 (2) ◽  
pp. 190
Author(s):  
Ian Smillie ◽  
Sophie Robertson ◽  
Anna Yule ◽  
David M. Wynne ◽  
Craig J. H. Russell
Keyword(s):  
Cleft Palate ◽  
Critical Appraisal ◽  
Ventilation Tube ◽  
Tube Insertion

scholarly journals Complications of Ventilation Tube Insertion in Children With and Without Cleft Palate

2014 ◽  
Vol 140 (10) ◽  
pp. 940 ◽  
Author(s):  
Ian Smillie ◽  
Sophie Robertson ◽  
Anna Yule ◽  
David M. Wynne ◽  
Craig J. H. Russell
Keyword(s):  
Cleft Palate ◽  
Ventilation Tube ◽  
Tube Insertion

Management of retraction pockets of the pars tensa in children by excision and ventilation tube insertion

1995 ◽  
Vol 109 (9) ◽  
pp. 817-820 ◽  
Author(s):  
R. M. Walsh ◽  
J. P. Pracy ◽  
L. Harding ◽  
D. A. Bowdler
Keyword(s):  
Ventilation Tube ◽  
Tube Insertion ◽  
Retraction Pocket ◽  
Pars Tensa ◽  
Retraction Pockets ◽  
Different Types ◽  
Grade Ii ◽  
Mean Time ◽  
Air Conduction

AbstractRetraction pockets of the pars tensa in children can result in erosion of the ossicles leading to hearing loss and eventually cholesteatoma formation. Several different types of treatment for the more severe grades of retraction pocket have been described. The aim of this pilot study was to assess the outcome following simple excision and ventiolation tube insertion of grade II, III and IV retraction pockets of the pars tensa. The eardrums were grades according to Sadé's classification (1979).There were seven grade II and four garade III ratractions. Ten eardrums healed completely in a mean time of 3.6 months (mean follow-up 16 months) and there was one residual perforation. Two retractions recurred and both of these were only grade I. Clinically, an improvement in hearing was reported in seven children (eight ears) and the average air conduction threshold gain for these patients was 16 dB. A larger prospective study is currently underway.

EVALUATING THE RESULTS OF TREATMENT FOR OTITIS MEDIA WITH EFFUSION BY VENTILATION TUBE INSERTION

2016 ◽  
pp. 81-86
Author(s):  
Phuoc Minh Hoang ◽  
Thanh Thai Le
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Clinical Intervention ◽  
Normal Function ◽  
Common Disease ◽  
Age Group ◽  
Ventilation Tube ◽  
Tube Insertion

Background: Otitis media with effusion (OME) is a common disease especially in children. Objective: To study clinical, tympanometry, audiometry and the results of ventilation tube insertion. Materials and methods: Prospective study with clinical intervention in 114 ears of 76 patients with OME. Results: The most common age group was ≤ 6 years of age (39.5%). Common symptoms in ≤6 years of age group are nasal obstruction (73.3%), rhinorrhea (66.7%); in > 6 years of age group are tinnitus (78.3%), hearing loss (76.1%). Tympanic membrane findings: completed opaque (40.4%), air-fluid level (64.1%), retraction (44.7%), losing cone of light (87.7%). Tympanograme type B was 78.1%. Audiograme was conductive hearing loss with PTA > 20 db (100%). Ventilation tube insertion one or both side associated with or without adenoidectomy. After 6 months of follow-up, postoperative average PTA was 28.4±1.6 dB. Most of cases have dry ear, hearing improvement, tubes on the tympanic membrane. Common complications were otorrhea and extrusion. Conclusion: OME is asymptomatic especially in children. Tympanograme plays a key role in diagnosis. Ventilation tube insertion improves the hearing and restores the normal function of the middle ear.

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