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

Smillie, Ian; Robertson, Sophie; Yule, Anna; Wynne, David; Russell, Craig

doi:10.1001/jamaoto.2015.38

Cited by 1 publication

(2 citation statements)

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“… 6 , 31 , 32 Ventilation tubes improve the tympanic membrane middle-ear ossicle complex compliance by drainage of the middle-ear effusion. 34 However, ventilation tubes are known to induce tympanosclerosis and can also lead to a chronic otitis epitympanalis or mesotympanalis. 31 , 34 , 35 Nevertheless, in order to enable a normal speech development, a chronic middle-ear effusion as well as a tympanosclerosis or chronic epitympanic or mesotympanic otitis should be treated.…”

Section: Discussionmentioning

confidence: 99%

“… 34 However, ventilation tubes are known to induce tympanosclerosis and can also lead to a chronic otitis epitympanalis or mesotympanalis. 31 , 34 , 35 Nevertheless, in order to enable a normal speech development, a chronic middle-ear effusion as well as a tympanosclerosis or chronic epitympanic or mesotympanic otitis should be treated. In this study, all patients showed hearing levels between − 5 and 20 dB HL bilaterally in the pure tone audiograms at the 5-year follow up.…”

Section: Discussionmentioning

confidence: 99%

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Middle-ear effusion in children with cleft palate: congenital or acquired?

2022

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Objective Cleft palates are one of the most common congenital malformations. Because of the loss of Eustachian tube function, middle-ear ventilation is reduced. The aim of this study was to determine if middle-ear effusions were present at birth or at the three-month audiological evaluation. Method A total of 53 children with a cleft palate were included. Data review included the results of newborn hearing screening, microscopic findings, a tympanometry, a free field audiometry and intra-operative findings. Results A total of 58.4 per cent of patients had a median, 26.4 per cent had a bilateral, 11.3 per cent had a unilateral and 3.8 per cent had a limited soft palate cleft. Newborn hearing screening showed a pass in 83.1 per cent of newborns bilaterally. The first ear microscopy showed a bilateral middle-ear effusion in 90.6 per cent of cases. During cleft surgery, bilateral paracentesis was performed in all cases, and in 90.6 per cent middle-ear effusion was sucked out. Conclusion The majority of children with a cleft palate do not present with middle-ear effusion at birth. It develops within several days or weeks of life.

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