scholarly journals MIDDLE EAR DISORDERS AMONG CLEFT LIP AND PALATE IN CHILDREN: A CONJOINT EXPOSITION

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S457-61
Author(s):  
Saba Islam ◽  
Nazia Mumtaz ◽  
Ghulam Saqulain

Objective: To analyze the frequency of middle ear disorders among the cleft lip and palate and association with hearing Loss. Study Design: Cross Sectional analytical study. Place and Duration of Study: Audiology Department of Cleft Hospital, Gujrat and ENT department of National Institute of Rehabilitation Medicine, Islamabad, from Oct 2018 to Mar 2019. Methodology: We recruited a sample of 100 cleft lip and palate children of both genders, aged 3 month to 12 years, using nonprobability sampling. Screening was performed with otoscopy, tympanometry and hearing assessment. Results: Out of sample population, 62% were males and 38% females with a mean age of 2.27 ± 2.73 years. The middle ear disorders were found to be 70%. Among these otitis media with effusion was the most common 43 (61.43%), followed by Acute otitis media 8 (11.43%) and Eustachian tube dysfunction 6 (8.57%). Tympanosclerosis and dry tympanic membrane perforation were the least common. Statistically significant association of hearing loss was found with the middle ear disorders (p<0.001). Conclusion: Middle ear disorders especially otitis media with effusion are common in cleft lip/ palate children.

Author(s):  
Fatemeh Mirashrafi ◽  
Babak Saedi ◽  
Mahtab Rabbani Anari ◽  
Gholamreza Garmaroudi ◽  
Roja Toosi ◽  
...  

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.


2019 ◽  
Vol 17 (2) ◽  
pp. 52-55
Author(s):  
Altaf Hussain ◽  
Wajahat Ullah Bangash ◽  
Muhammad Ismail Khan ◽  
Muhammad Afaq Ali ◽  
Ali Khan ◽  
...  

Background: Children with cleft palate oftenly present with otitis media with effusion. The objective of this study was to determine the frequency of otitis media with effusion among cleft palate children. Material & Methods: This cross-sectional study was carried out in the Department of ENT, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from June 2017 to December 2018. Ninety patients were selected through consecutive sampling technique. All children 3-10 years of age with cleft palate were included. Patients with combined cleft palate and cleft lip were excluded. All patients underwent otoscopy and tympanometry. Type B tympanogram was considered as evidence of fluid in the middle ear. Later on patients with only Type B tympanogram underwent myringotomies. Results: Out of 90 (180 ears) patients 61 (67.78%) were males and 29 (32.22%) females. Mean age of the sample was 6.15±2.226 years (3-10, range 7 years). On otoscopic examination, 107/180 (59.45%) ears were suspected to have fluid in the middle ear. Type B tympanogram was detected in 125/180 (69.45%) ears. Only 38/90 (42.20%) patients (76/180 ears), underwent pure tone audiometry. Based on otoscopic, tympanometric and audiometric findings, myringotomies were performed in 125/180 (69.45%) ears. At myringotomy fluid was present in middle ear space of 98/180 (78.4%) ears. Out of total 180 ears the true frequency of otitis media with effusion was 98/180 (54.45%). Conclusions: The frequency of otitis media with effusion in patients with cleft palate is high. Tympanometry is fairly sensitive in diagnosing this condition in these patients.


2016 ◽  
Vol 45 (2) ◽  
pp. 131
Author(s):  
Duhita Yassi ◽  
Dini Widiarni ◽  
Tri Juda Airlangga ◽  
Lestaria Aryanti ◽  
Muchtarudin Mansyur

Latar belakang: Celah bibir dan palatum merupakan kelainan proses pertumbuhan area orofasial yang menimbulkan permasalahan kompleks. Penelitian ini menitikberatkan permasalahanyang terkait dengan fungsi bicara. Tujuan: Penelitian ini melaporkan gambaran skor nasalance padacelah palatum, hubungan antara skor nasalance percontoh celah palatum dan tanpa celah palatum sertafaktor-faktor yang berhubungan dengan skor nasalance. Metode: Desain penelitian adalah comparativecross sectional. Pengambilan percontoh dilakukan dengan purposive sampling. Dilakukan wawancara,pengisian kuesioner, pemeriksaan THT, audiometri, timpanometri, nasoendoskopi, dan nasometri.Hasil: Didapatkan gambaran rerata skor nasalance percontoh celah palatum. Terdapat  perbedaanbermakna antara skor nasalance percontoh celah palatum dan tanpa celah palatum pada Uji Gajah danUji Hantu (p<0,001). Pada analisis multivariat secara keseluruhan faktor-faktor yang berhubungandengan skor nasalance (adenoid, otitis media efusi, serta gangguan pendengaran) dan keberadaancelah palatum berpengaruh secara signifikan terhadap skor nasalance untuk semua uji nasalance(p<0,05) pada pengujian terhadap kedua kelompok percontoh. Bila dilihat secara parsial faktor adenoidberpengaruh secara signifikan terhadap skor semua uji nasalance baik pada analisis kedua kelompokpercontoh maupun pada percontoh celah palatum saja. Kesimpulan: Rerata skor nasalance kelompokcelah palatum lebih tinggi daripada kelompok tanpa celah palatum. Didapatkan peran faktor yangberpengaruh terhadap skor nasalance, khususnya adenoid. Diperlukan penelitian lebih lanjut terhadappercontoh sesudah operasi sehingga bisa dijadikan sebagai evaluasi terhadap keberhasilan tindakan. Kata kunci: celah palatum, skor nasalance, tonsil, adenoid, otitis media efusi, gangguan pendengaran ABSTRACTBackground: Cleft lip and palate is an orofacial malformation and associated with many problems. This study concerned in speech problem in cleft palate patients. Purpose: This study reportednasalance score in cleft palate patients, the correlation between nasalance score in cleft palate and noncleft palate groups and also some factors related with nasalance score in cleft palate patients. Methods:The design of this study was comparative cross sectional, with purposive sampling. Data was collectedwith interview, questioner apllication, ENT examination, audiometry, tympanometry, nasoendoscopy,and nasometry. Results: The result of this study reported the mean of nasalance score in cleft palatepatients. There was significant difference in nasalance score between cleft palate and non cleft palatepatients in Uji Gajah and Uji Hantu (p>0,05). In multivariate analysis, in general the factors relatedwith nasalance score (adenoid, otitis media with effusion, and hearing loss) and cleft palate  itself weresignificantly correlated with nasalance score in all nasalance test (p<0,05) in both groups analysis butno signifficant correlation in cleft palate group analysis. Partially, adenoid  was significantly correlated in both group analysis and cleft palate group analysis. Conclusion: The mean of nasalance score incleft palate group was higher than non cleft group. Some factors in this study, especially adenoid had corelations with nasalance score. It needs further study to evaluate the nasalance score patients withcleft palate after surgery to compare the results. Keywords: cleft palate, nasalance score, tonsil, adenoid, otitis media with effusion, hearing disturbance


2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Altaf Hussain ◽  
Wajahat Ullah Bangash ◽  
Muhammad Ismail Khan ◽  
Muhammad Afaq Ali ◽  
Ali Khan ◽  
...  

Background: Children with cleft palate oftenly present with otitis media with effusion. The objective of this study was to determine the frequency of otitis media with effusion among cleft palate children. Material & Methods: This cross-sectional study was carried out in the Department of ENT, Pakistan Institute of Medical Sciences, Islamabad, Pakistan from June 2017 to December 2018. Ninety patients were selected through consecutive sampling technique. All children 3-10 years of age with cleft palate were included. Patients with combined cleft palate and cleft lip were excluded. All patients underwent otoscopy and tympanometry. Type B tympanogram was considered as evidence of fluid in the middle ear. Later on patients with only Type B tympanogram underwent myringotomies. Results: Out of 90 (180 ears) patients 61 (67.78%) were males and 29 (32.22%) females. Mean age of the sample was 6.15±2.226 years (3-10, range 7 years). On otoscopic examination, 107/180 (59.45%) ears were suspected to have fluid in the middle ear. Type B tympanogram was detected in 125/180 (69.45%) ears. Only 38/90 (42.20%) patients (76/180 ears), underwent pure tone audiometry. Based on otoscopic, tympanometric and audiometric findings, myringotomies were performed in 125/180 (69.45%) ears. At myringotomy fluid was present in middle ear space of 98/180 (78.4%) ears. Out of total 180 ears the true frequency of otitis media with effusion was 98/180 (54.45%). Conclusions: The frequency of otitis media with effusion in patients with cleft palate is high. Tympanometry is fairly sensitive in diagnosing this condition in these patients.


Author(s):  
Vijayalakshmi Subramaniam ◽  
Manuprasad S ◽  
Hebin H. Kallikkadan ◽  
Vijay Kumar K

<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.


2003 ◽  
Vol 71 (6) ◽  
pp. 3454-3462 ◽  
Author(s):  
Kevin M. Mason ◽  
Robert S. Munson ◽  
Lauren O. Bakaletz

ABSTRACT The gram-negative bacterium nontypeable Haemophilus influenzae (NTHI) is the predominant pathogen in chronic otitis media with effusion and, with Streptococcus pneumoniae and Moraxella catarrhalis, is a causative agent of acute otitis media. To identify potential virulence determinants, bacterial gene expression was monitored by differential fluorescence induction during early disease progression in one specific anatomical niche of a chinchilla model of NTHI-induced otitis media. Genomic DNA fragments from NTHI strain 86-028NP were cloned upstream of the promoterless gfpmut3 gene. NTHI strain 86-028NP served as the host for the promoter trap library. Pools of 2,000 transformants were inoculated into the left and right middle ear cavities of chinchillas. Middle ear effusions were recovered by epitympanic tap at 24 and 48 h, and clones containing promoter elements that were induced in vivo and producing green fluorescent protein were isolated by two-color fluorescence-activated cell sorting. Insert DNA was sequenced and compared to the complete genome sequence of H. influenzae strain Rd. In a screen of 16,000 clones, we have isolated 44 clones that contain unique gene fragments encoding biosynthetic enzymes, metabolic and regulatory proteins, and hypothetical proteins of unknown function. An additional eight clones contain gene fragments unique to our NTHI isolate. Using quantitative reverse transcription-PCR, we have confirmed that 26 clones demonstrated increased gene expression in vivo relative to expression in vitro. These data provide insight into the response of NTHI bacteria as they sense and respond to the middle ear microenvironment during early events of otitis media.


1984 ◽  
Vol 22 (14) ◽  
pp. 53-54

Acute suppurative otitis media (AOM) is a common, painful condition affecting 20% of children under 4 years at least once a year,1 and perhaps more in infancy when clinical examination is most difficult. Infectious complications such as mastoiditis, meningitis and cerebral abscess are now rare, but chronic middle ear effusion and hearing loss remain common. Hearing loss may persist long after the infective episode,2 and may impair learning.


1998 ◽  
Vol 107 (10) ◽  
pp. 876-884 ◽  
Author(s):  
Yoshiharu Ohno ◽  
Yoshihiro Ohashi ◽  
Hideki Okamoto ◽  
Yoshikazu Sugiura ◽  
Yoshiaki Nakai

The effect of platelet activating factor (PAF) was studied to elucidate its role in the pathogenesis of otitis media and sensorineural hearing loss. The PAF alone did not induce a reduction of ciliary activity of the cultured middle ear mucosa. However, a dose-dependent decrease in ciliary activity was observed in the presence of the medium containing both PAF and macrophages. Intravenous injection of PAF did not induce dysfunction of the mucociliary system or morphologic changes of epithelium in the tubotympanum, but cytoplasmic vacuolization and ballooning were observed in the inner ear within 1 hour after injection of PAF. In contrast, intratympanic injection of PAF induced mucociliary dysfunction and some pathologic changes in the tubotympanum. Intratympanic inoculation of PAF induced no pathologic findings in the inner ear. These results suggest that PAF is at least partially involved in the pathogenesis of certain middle ear diseases such as otitis media with effusion. Additionally, PAF might be involved in the pathogenesis of some types of unexplained sensorineural hearing loss.


1992 ◽  
Vol 107 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Patrick J. Antonelli ◽  
Steven K. Juhn ◽  
Marcos V. Goycoolea ◽  
G. Scott Giebink

Previous experiments have shown that Pseudomonas aeruginosa may infect the middle ears of chinchillas by way of the eustachian tube and that chinchillas with acute otitis media (AOM) are more susceptible to pseudomonas infection than animals without AOM. The purpose of this experiment was to examine the effects of otitis media with effusion (OME), induced by means of eustachian tube obstruction, on middle ear susceptibility to nasal inoculation of P. aeruginosa. Chinchilla eustachian tubes were obstructed with silicone rubber sponge bilaterally; OME developed in eight animals (11 ears)—three bilaterally and five unilaterally—and persisted for 6 months. Ten chinchillas with normal eustachian tube function served as controls. All animals were nasally inoculated with 5 times 104 colony-forming units of P. aeruginosa. Pseudomonas otitis media developed in eight of 11 OME ears with effusion, none of five ears without OME, and four of 20 control ears (X2 = 11.782, p = 0.003). Therefore, P. aeruginosa can infect the middle ear by way of the eustachian tube. Tubal dysfunction may lead to the development of chronic suppurative otitis media by increasing tubotympanic susceptibility to opportunistic pathogens.


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