Evaluating the Frequency of Ear Problems in Patients with Cleft Lip and Palate

2021 ◽  
Author(s):  
Fatemeh Mirashrafi ◽  
Babak Saedi ◽  
Mahtab Rabbani Anari ◽  
Gholamreza Garmaroudi ◽  
Roja Toosi ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Otitis Media ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Pure Tone Audiometry ◽  
Hearing Disorders ◽  
Conductive Hearing

Background: Orofacial cleft is one of the most common congenital malformations of craniofacial region. Otitis media with effusion causing conductive hearing loss is a considerable challenge for many children with cleft lip and palate. The aim of this study was to evaluate the prevalence of hearing disorders and associated malformations in these patients. Methods: The research population consisted of patients with cleft palate, between years 2012 and 2014, who were referred to Children’s Medical Center and Vali-e-Asr hospital in Tehran, Iran. Otoscopic examination, tympanometry, pure tone audiometry and echocardiography were performed for each patient. Results: Among patients with cleft palate, 73% suffered from hearing disorders. There was no relationship between prevalence of hearing loss and sex, presence of other congenital anomalies and degree of cleft, but middle ear diseases were significantly higher in children younger than 2 years. Among patients with cleft lip or palate, 10% suffered from cleft lip, 63% suffered from cleft palate and 27% suffered from cleft lip and palate. There was at least one congenital anomaly in 53% of patients. Conclusion: This study demonstrates high prevalence of otitis media with effusion and conductive hearing loss in patients with cleft. However, audiologic problems are alleviated when patients become older.

scholarly journals Ear Findings and Hearing analysis in cleft palate patients in Nepal

2019 ◽  
Vol 10 (2) ◽  
pp. 52-57
Author(s):  
Sanjeev Thakur ◽  
Baleshwar Yadav ◽  
Manish Agrawal ◽  
Kailash Khaki Shrestha ◽  
Raj Kumar Bedajit
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Tympanic Membrane ◽  
Pure Tone ◽  
Cleft Lip ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
P Value ◽  
Age Group ◽  
Conductive Hearing

Background: The orofacial cleft is the most common birth anomaly with a prevalence rate ranging from 1/1000 to 2.69/ 1000. The middle ear diseases are known to be associated with cleft palate, however, the prevalence and the magnitude of the condition is usually underestimated. Aims and Objectives: The purpose of this study was to find out the various exisiting ear abnormalities, to assess the middle ear function and hearing status  in patients with cleft palate and confirm the existence of these manifestations and their significance. Materials and Methods: All the patients with cleft palate with or without cleft lip over a one-year duration from January to December 2018 at the teaching hospital were include after informed consent. The patients with only cleft lip were excluded. General ENT examination and Otoscopy was performed.  Tympanometry and Pure tone Audiometry was done (in those above 5 years). The degree of hearing loss was categorized using the WHO guidelines. Results: Out of a total of 56 patients, there were 30(53.6%) male and 26(46.4%) female. The age range was from 2years to 31 years. The mean age was 12.8 years. Maximum number of patients were in the 10-20 years age group 29(51.8%) followed by 22 (39.3%) in the less than 10 years age group. 53 (47.3%) of 112 ears examined  had dull tympanic membrane, followed by retraction of tympanic membrane in 42 (37.5%) ears. Other findings were central perforation in 5 (4.5%), bulging tympanic membrane in 2 (1.8%) and atticoantral disease in 1 (0.9%) ear. 8 (7.1%) ears  had normal findings. There was one case with right ear atresia (0.9%). In Tympanometry findings, the maximum number of ears, 51 (48.1%) had  type B curve, followed by 33 (31.2%) ears with type As curve. 16 (15%) of ears had type C curve. 6 (5.7%) ears had type A curve. B type curve was found more common in less than 10 years age group. A chi Square test was performed and the findings had statistically significant association.  (P value: 0.03 for Right ear tympanometry ; P value: 0.043 for left ear tympanometry). In Pure tone audiometry findings of 105 ears, 72 (68.6%) ears had mild conductive hearing loss. 10 (9.5%) ears had moderate conductive hearing loss, while 1 (1%) ear had mixed hearing loss. 22 (20.9%) ears had normal hearing level. Conclusion: This study assessed the common ear problems prevalent in cleft patients, along with the hearing loss. Since, ear disease were quite common in these patients, these patients should be evaluated regularly by an otolaryngologist to detect, treat and prevent such problems in these patients so that long term morbidity could be avoided. 

scholarly journals Otological and audiological manifestations in cleft lip and cleft palate children: a clinical study

2015 ◽  
Vol 1 (1) ◽  
pp. 7 ◽  
Author(s):  
Vijayalakshmi Subramaniam ◽  
Manuprasad S ◽  
Hebin H. Kallikkadan ◽  
Vijay Kumar K
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Cleft Lip ◽  
Otitis Media With Effusion ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
College Hospital ◽  
Orofacial Region

<p class="abstract"><strong>Background:</strong> Cleft lip and cleft palate are the commonest congenital anomalies of the orofacial region. The<strong> </strong>incidence of middle ear problems and hearing loss is reported to be higher in children with cleft palate &amp;/or cleft lip.</p><p class="abstract"><strong>Methods:</strong> A prospective, observational case-control study comprising 80 subjects (40 cases and 40 controls) was undertaken at Yenepoya Medical College Hospital, Mangalore, Karnataka, India. All subjects enrolled were subjected to detailed ENT examination including otoscopy, pure tone audiometry and impedance audiometry.  </p><p class="abstract"><strong>Results:</strong> Retracted tympanic membrane suggestive of Otitis Media with Effusion (OME) and conductive hearing loss was observed in more than 50% of patients with cleft palate &amp;/or cleft lip. Tympanogram of B type suggesting OME was observed in 27% of cases. Chronic otitis media was observed in 32.5% of cases.</p><strong>Conclusions:</strong> The prevalence of OME, Chronic otitis media and hearing loss was observed to be higher among children with cleft palate &amp;/or cleft lip. Otological and audiometric assessment should be performed for all patients having cleft palate &amp;/or cleft lip atleast before surgery in order to facilitate early identification and intervention for middle ear problems particularly middle ear effusion.

scholarly journals Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media

2013 ◽  
Vol 5 (3) ◽  
pp. 133-138
Author(s):  
Sunali Khanna ◽  
R Rangasayee
Keyword(s):  
Hearing Loss ◽  
Down Syndrome ◽  
Otitis Media ◽  
Eustachian Tube ◽  
Conductive Hearing Loss ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Predisposing Factor ◽  
Lateral Cephalometry ◽  
Conductive Hearing

ABSTRACT Objective Cephalometric assessment of Eustachian tube (ET) parameters and audiological evaluation in Down syndrome (DS) and Chronic Otitis Media (COM) and comparison with controls. The ET length, Total Cranial Base (TCB), Posterior Upper Facial Height (PUFH), Maxillary Depth (MD), s-ba (sella-basion) to Palatal Line (PL) and s-ba to ET length were considered. Materials and methods The study comprised of 75 subjects of both sexes in the age range of 7 to 20 years. Digital lateral cephalometry was performed for DS, COM and controls (n = 25). Pure tone audiometry (PTA) and immittance audiometry (IA) was performed to assess audiological status. Results ET length, PUFH, TCB and MD was found to be significantly reduced in DS and COM. s-ba to PL and s-ba to ET was significantly reduced in DS and COM. The s-ba to PL and s-ba to ET length angle in moderate and severe CHL (Conductive Hearing Loss) was decreased significantly. The s-ba to ET length was significantly decreased in patients with B and C tympanogram. Conclusion Aberration in the dimension of the region of the ET can be considered as a predisposing factor for otitis media and conductive hearing loss in DS. How to cite this article Khanna S, Rangasayee R. Cephalometric and Audiological Assessment of Eustachian Tube in Down Syndrome and Chronic Otitis Media. Int J Otorhinolaryngol Clin 2013;5(3):133-138.

Development and Resolution of Nasal Fricatives in a Child With Repaired Bilateral Cleft Lip and Palate: A Case Report

2021 ◽  
pp. 1-12
Author(s):  
David J. Zajac ◽  
Juliana Powell ◽  
Margaret McQuillan
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Cleft Lip ◽  
Speech Therapy ◽  
Cleft Lip And Palate ◽  
Conductive Hearing Loss ◽  
Multiple Factors ◽  
Air Emission ◽  
Bilateral Cleft Lip ◽  
Conductive Hearing

Purpose This case report describes the development, characteristics, and resolution of anterior nasal fricatives (ANFs)—a learned maladaptive articulation error—in a young girl with repaired bilateral cleft lip and palate. Method The girl was observed every 2 months from 12 to 24 months of age with follow-ups at 36, 48, and 67 months of age. Results At 12 months of age, the girl nasalized /b/ inconsistently and had mild conductive hearing loss. At 18 months of age, she exhibited audible nasal air emission on some plosives and used ANFs to replace /s/ and /z/, often with a nasal grimace. At 24 months of age, the child continued to experience mild conductive hearing loss, obligatory nasal air emission, and ANFs for /s/ and /z/. At 36 months of age, pressure-flow testing documented significant velopharyngeal (VP) dysfunction. The girl then used ANFs for /f/ and /s/, phonetically marked by different oral stops. At 48 months of age, although VP impairment continued, speech therapy largely eliminated ANFs. By 67 months of age, VP closure was nearly normal. Conclusions Multiple factors including VP dysfunction, audible nasal air emission, and conductive hearing loss contributed to the development of ANFs. Clinical and etiological implications are discussed.

Auditory Brainstem Responses in Children with Otitis Media with Effusion

1980 ◽  
Vol 89 (3_suppl) ◽  
pp. 200-206 ◽  
Author(s):  
Thomas J. Fria ◽  
Diane L. Sabo
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
School Age Children ◽  
School Age ◽  
Conductive Hearing

Auditory brainstem responses (ABR) were recorded in 14 infants and toddlers and 12 school-age children with a previous history of recurrent otitis media with effusion (OME), or otoscopic and tympanometric evidence of persistent OME, or both. ABR tests were performed immediately before and after myringotomy and tympanostomy tube insertion in the younger subjects. For the school-age children, ABR tests were performed following otoscopy, tympanometry, and pure tone audiometry. The results demonstrate that the latency of both wave I and wave V of the ABR was sensitive (82% and 100%, respectively) to the presence of OME. Wave I also identified the absence of OME (specificity = 100%) whereas wave V did not (specificity = 25%). ABR latency was significantly decreased postoperatively in ears found to have OME, but not in ears found to have no OME. In the school-age subjects the ABR was used to predict the conductive hearing loss at 4000 Hz with less than a 20 dB error in virtually all subjects. The ABR latency delay was also found to be related to conductive hearing impairment at lower pure tone frequencies and to the average conductive loss at a variety of pure tone frequencies. Predictions of the presence of a conductive hearing loss from these relationships promise to be impressively accurate. The results suggest that the ABR can be a valuable tool for detecting the presence of conductive hearing impairment in infants and young children suspected to have OME and perhaps as an estimate of the degree of impairment.

Congenital Conductive Hearing Loss in Apert Syndrome

1986 ◽  
Vol 95 (4) ◽  
pp. 429-433 ◽  
Author(s):  
Susan G. Phillips ◽  
Richard T. Miyamoto
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Conductive Hearing Loss ◽  
Otitis Media With Effusion ◽  
Apert Syndrome ◽  
Review Of The Literature ◽  
Stapes Fixation ◽  
The Third ◽  
Hands And Feet ◽  
Conductive Hearing

Acrocephalosyndactyly (Apert syndrome) is a rare cranlosynostotic syndrome characterized by acrocephaly, syndactyly of the hands and feet, and—occasionally—-conductive hearing loss. We report three cases of conductive hearing loss in Apert syndrome. One patient was found to have bilateral stapes fixation. His daughter (the second case) had chronic bilateral otitis media with effusion. The third case involved a fixed Incus and hypomobile stapes. The management of these patients and a review of the literature are presented.

Predictive role of Carhart's notch in pre-operative assessment for middle-ear surgery

2006 ◽  
Vol 121 (3) ◽  
pp. 219-221 ◽  
Author(s):  
H Yasan
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Middle Ear ◽  
Pure Tone ◽  
Conductive Hearing Loss ◽  
Pure Tone Audiometry ◽  
Stapes Footplate ◽  
Predictive Role ◽  
Conductive Hearing

Objectives: To evaluate the predictive role of the audiometric Carhart's notch for the assessment of middle-ear pathology prior to surgical intervention.Method: In this retrospective analysis, a total of 315 operated ears of 305 patients were evaluated regarding their pre-operative pure tone audiograms and peri-operative findings. The probable relationship between the middle-ear pathologies found and the Carhart's notch found on pre-operative pure tone audiometry was investigated. Patients with conductive hearing loss who obtained at least a 10 dB improvement (at 1 and 2 kHz frequencies) in their bone conduction threshold post-operatively were included in the Carhart's notch group. The pathologies underlying Carhart's notch were compared.Results: Three hundred and fifteen ears of 305 consecutive patients with conductive hearing loss were operated on due to middle-ear pathology. In patients with otosclerosis and tympanosclerosis, a Carhart's notch was seen at 2 kHz in 28 (93 per cent) patients but at 1 kHz in only two (7 per cent). However, in patients with chronic otitis media, a Carhart's notch was seen at 1 kHz in 10 (55 per cent) patients and at 2 kHz in eight (45 per cent) patients.Conclusions: Otitis media with effusion, tympanosclerosis and congenital malformations should be considered in the differential diagnosis of a patient with a Carhart's notch seen on pure tone audiometry. A Carhart's notch at 2 kHz indicates stapes footplate fixation, whereas one at 1 kHz indicates a mobile stapes footplate; the footplate mobility can thus be predicted pre-operatively.

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