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 ◽  
...  

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.

1996 ◽  
Vol 33 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Patricia A. Broen ◽  
Karlind T. Moller ◽  
Jane Carlstrom ◽  
Shirley S. Doyle ◽  
Monica Devers ◽  
...  

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.


2017 ◽  
Vol 55 (4) ◽  
pp. 590-595 ◽  
Author(s):  
Kitirat Ungkanont ◽  
Panrasee Boonyabut ◽  
Chulaluk Komoltri ◽  
Archwin Tanphaichitr ◽  
Vannipa Vathanophas

Objective: To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Design: Retrospective cohort study in the tertiary care center. Patients: Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Main outcome measures: Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Results: Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Conclusion: Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.


2001 ◽  
Vol 94 (2) ◽  
pp. 113-117
Author(s):  
Ryuichi Kobayashi ◽  
Hiroshi Furuta ◽  
Hiroshi Hoshikawa ◽  
Rieko Goto ◽  
Masayuki Karaki ◽  
...  

1988 ◽  
Vol 81 (12) ◽  
pp. 710-713 ◽  
Author(s):  
R S Dhillon

A multicentre prospective trial was commenced in July 1984 to establish the incidence of otitis media with effusion (OME) in children born with a cleft of the palate. Additionally, the data recorded would allow an assessment of the effect of palatal closure on middle ear function. Prior to palatal closure, 97% of ears in a group of 50 patients had otitis media with effusion (OME). The insertion of a long-term ventilation tube provided a means of aeration of one ear with the non-ventilated ear acting as a control. Eighty percent of control ears had persistent OME during a 24-month follow-up period post palatal repair. It would seem that OME is universally present in children with a cleft palate prior to 4 months of age and this incidence is only marginally diminished by palatal surgery. The liaison between plastic surgical and ENT units should be even closer than before in order to manage these patients satisfactorily.


2021 ◽  
Vol 73 ◽  
pp. 245-251
Author(s):  
Kitirat Ungkanont ◽  
Alisa Tabthong ◽  
Chulaluk Komoltri ◽  
Amornrut Leelaporn ◽  
Vannipa Vathanophas ◽  
...  

Objective: To study the long-term outcome of otitis media with effusion in children with and without cleft palate treated with the same protocol of ventilation tube insertion. Materials and Methods: A retrospective cohort study was conducted in eighty-five children with cleft palate and 80 children without cleft palate who had otitis media with effusion and had follow-up between 2001 and 2019. Both groups were treated with ventilation tube insertion for longstanding middle ear effusion more than 90 days. The main outcome was the cumulative incidence of surgical management, time of the indwelling ventilation tubes, conditions of the tympanic membrane, and the hearing outcome. Results: At 24 months old, 63.5% of children with cleft palate and 11.3% of children without cleft palate had their first ventilation tube insertion. Repeated surgery was done in 81.2% of children with cleft palate and 50% of children without cleft palate (p < 0.001). The median duration of the indwelling tube was 11.3 months in the children with cleft palate and 12.4 months in the non-cleft children (p = 0.82). At the end of the study, 63.7% of children without cleft palate and 43.5% of children with cleft palate had normal tympanic membrane (p = 0.009). The hearing outcomes of children with and without cleft palate were 20.7 dB and 19.3 dB, respectively. Conclusion: Children with and without cleft palate were managed under the same guideline and the hearing outcome was favorable in both groups.


2021 ◽  
pp. 014556132110264
Author(s):  
Shunsuke Takai ◽  
Kazuhiro Nomura ◽  
Kiyoshi Oda ◽  
Daiki Ozawa ◽  
Mihoko Irimada ◽  
...  

Background: Ventilation tube (VT) insertion is the most common treatment for otitis media with effusion (OME). However, OME recurrence and persistent tympanic membrane (TM) perforation after VT removal are encountered in a certain percentage of such children. Methods: This study was performed to determine the outcomes of children who underwent long-term VT insertion. A total of 326 ears from 192 patients were analyzed. The associations among the patient age, sex, history of OME, history of repeated acute otitis media, placement duration, whether the VT had been removed intentionally or spontaneously, and the outcome (persistent TM perforation or OME recurrence) were analyzed. The outcomes of multiple VT tube insertions were also reviewed. We also analyzed whether or not local or general anesthesia was associated with the early spontaneous extrusion of the VT. Result: The OME recurrence and TM perforation rates were 29% (96/326 sides) and 17% (57/326 sides), respectively, for first insertions. In addition, 96 (29%) sides underwent ≥2 insertions. The shorter the duration for which the VT was retained in the middle ear, the more significant the rate of increase in OME recurrence. The OME recurrence was observed more often when VT was spontaneously removed than when intentionally removed. The rate of persistent TM perforation was significantly associated with male sex. Persistent TM perforation was not observed in patients who underwent 4 or 5 insertions. The anesthesia method did not significantly influence the timing of spontaneous extrusion of VT. Conclusion: The retention period of VT should be at least 2 years, and VT removal at the age of 7 might be a viable strategy. Multiple VT insertions are recommended for patients with recurrent OME. Ventilation tube under local anesthesia is an effective option for tolerable children.


2006 ◽  
Vol 120 (7) ◽  
pp. 556-560 ◽  
Author(s):  
B Abdullah ◽  
S Hassan ◽  
D Sidek ◽  
H Jaafar

Introduction: Otitis media with effusion (OME) is an inflammation of the middle ear in which a collection of liquid is present in the middle-ear space while the tympanic membrane is intact. The association between adenoid inflammation and OME has long been noted but the exact mechanism is still much debated. We studied the role of adenoid mast cells in the causation of OME.Objective: To study the distribution and role of adenoid mast cells in the causation of OMEMethodology: A cross-sectional, prospective study was carried out in the otorhinolaryngologic clinic, department of otorhinolaryngology (ORL), Science University of Malaysia, from June 1999 to September 2001. A total number of 50 cases were studied. Twenty-five of these patients underwent adenoidectomy, while another 25 patients underwent adenoidectomy and myringotomy with ventilation tube insertion. The adenoid specimens from all patients were examined for the number of adenoid mast cells present, using light microscopy and toluidine blue as the staining agent. The results were analysed using SPSS version 10.0 computer software.Result: The population of adenoid mast cells in children with OME was significantly greater than that in children without OME (p = 0.000).Conclusion: The increased number of adenoid mast cells in patients with OME suggests that inflammation may play a role in this condition.


2018 ◽  
Vol 33 (2) ◽  
pp. 14-20
Author(s):  
Abner L. Chan ◽  
Ryner Jose D. Carrillo ◽  
Kimberly C. Ong

Objective: To develop a ventilation tube insertion simulator for training and evaluation of otorhinolaryngology residents in myringotomy with ventilating tube insertion. Methods:             Design:            Cross - Sectional Study             Setting:           Tertiary National University Hospital             Participants:   Otologists and otorhinolaryngology resident trainees A simulation tool for myringotomy with ventilation tube insertion was fabricated using silicone sealant, aluminum tube, rubber ball, plaster of paris and plastic sheet, and pretested by our expert panel. Residents were then evaluated using an objective structured clinical examination (OSCE) checklist while performing the procedure using the same model. Three trials were given, and OSCE scores were obtained, for each resident. Result: The pinna, ear canal, tympanic membrane, malleus handle were deemed realistic by the expert panel. Residents performed the procedure at an average of 87 seconds. Average OSCE score for all residents was 17.17, with senior residents having a higher average score (18.3) than junior residents (16.6). However, this was not statistically significant (2 tailed t-value, significance level 0.05 = -1.27, p = .227). The most common cause of trial failure was dropping of the tube in the middle ear, while the most common error made was using more than 2 attempts at performing the incision. Conclusion:  This simulation platform may be a valuable tool to use in educating and developing skills and proper technique of myringotomy with ventilation tube insertion. It is reproducible, affordable, realistic, sturdy and versatile in its applications. Residents who show adequate dexterity and consistency during simulation may eventually be allowed to perform the procedure on patients and provide feedback regarding the usefulness of the simulation. Keywords: otitis media with effusion, middle ear ventilation, tympanic membrane, models, educational, simulation training, patient simulation


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