Eustachian Tube Function in OME Patients with Cleft Palate: Special Reference to the Prognosis of Otitis Media with Effusion

Tasaka, Yasuyuki; Kawano, Michio; Honjo, Iwao

doi:10.3109/00016489009124802

Cited by 15 publications

(6 citation statements)

References 3 publications

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“…The eustachian tube may be abnormally compliant, and may allow positive pressures in the nasopharynx to be transmitted to the middle ear, 192 causing nasopharyngeal pathogens to reflux into the middle ear. Cleft palate patients with OME have been shown to have abnormally compliant eustachian tubes 193,194 …”

Section: Why Is the Effusion Not Cleared Effectively?mentioning

confidence: 99%

The aetiology of otitis media with effusion: a review

2000

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Otitis media with effusion (OME) is the most common cause of deafness in children in the developed world. In this article we aim to present an overview of current research developments on the aetiology of OME and the resulting implications for treatment. In the model we describe, the primary event is inflammation of the middle ear mucosa, usually due to the presence of bacteria. This leads to the release of inflammatory mediators, which cause secretion of a mucin-rich effusion by up-regulating mucin genes. Prolonged stimulation of the inflammatory response and poor mucociliary clearance lead to persistence of the middle ear fluid, giving rise to the clinical presentation of OME. We describe OME in the following sequence: the initial production of the effusion, the composition of the effusion produced, and factors impairing clearance of the effusion.

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Section: Why Is the Effusion Not Cleared Effectively?mentioning

confidence: 99%

The aetiology of otitis media with effusion: a review

2000

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“…Past studies of ET function in CP patients both before and after palate repair document an inability to open the ET during activities typically associated with mTVP contraction (e.g., swallowing), as well as other functional abnormalities (Bluestone, 1971; Bluestone et al, 1975; Doyle et al, 1980; Doyle et al, 1986; Tasaka et al, 1990; Takahashi et al, 1994). Because the two muscles intimately associated with the ET—the mTVP and the mLVP—have insertions within the palate, OME in CP patients has been attributed to ET dysfunction caused by abnormal interactions between those muscles and the ET (Huang et al, 1997).…”

mentioning

confidence: 99%

Finite Element Analysis of Eustachian Tube Function in Cleft Palate Infants Based on Histological Reconstructions

Sheer

Swarts

Ghadiali

2010

The Cleft Palate-Craniofacial Journal

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“…Therefore, differences in middle ear outcomes may be expected with different palatoplasty techniques. However, eustachian tube dysfunction commonly persists after palatoplasty (Doyle et al, 1986; Dhillon, 1988; Tasaka et al, 1990; Robinson et al, 1992; Rynnel-Dagoo et al, 1992; Nunn et al, 1995). Past studies comparing palatoplasty techniques (Guneren et al, 2000; Kane et al, 2000) have generally failed to demonstrate a clear impact of different palatoplasty techniques.…”

Section: Discussionmentioning

confidence: 99%

“…Tensor veli palatini function improves after palate repair, but this may never normalize (Doyle et al, 1986). Thus, COME remains a common problem after palatal surgery (Dhillon, 1988; Tasaka et al, 1990; Matsune et al, 1991b; Robinson et al, 1992; Rynnel-Dagoo et al, 1992; Nunn et al, 1995). Persistent eustachian tube dysfunction is also thought to be the primary factor responsible for the higher rates of more serious middle ear pathology observed in children with cleft palate, such as middle ear atelectasis, tympanic membrane perforation, and cholesteatoma (Dominguez and Harker, 1988; Goldman et al, 1993; Muntz, 1993; Smith et al, 1994; Nunn et al, 1995; Bluestone and Klein, 1996).…”

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confidence: 99%

Otologic and Audiologic Outcomes with the Furlow and von Langenbeck with Intravelar Veloplasty Palatoplasties in Unilateral Cleft Lip and Palate

Antonelli

Jorge

Feniman

et al. 2011

The Cleft Palate-Craniofacial Journal

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Objective Cleft palate increases the risk of chronic middle ear disease and hearing loss. The goal of this report was to determine which of two palate surgeries and which timing of palate surgery were associated with better otologic and audiologic outcomes in children with unilateral cleft lip and palate at 5 to 6 years of age. Design Subjects were randomly assigned to the von Langenbeck with intravelar veloplasty or Furlow palate repair, to palate surgery at 9 to 12 months or 15 to 18 months of age, and to the Spina or Millard lip repair. Setting Centralized, tertiary care craniofacial treatment center. Patients A total of 673 infants with unilateral cleft lip and palate. Interventions Palate and lip were repaired using established techniques. Serial otoscopic and audiometric evaluations were performed. Main Outcome Measures Hearing and otoscopic findings at 5 to 6 years old. Results There were 370 children available for analysis. Hearing and need for tympanostomy tube placement did not differ by palatoplasty, age at palatoplasty, cheiloplasty, or surgeon. Risk of developing cholesteatoma or perforation was higher with Millard cheiloplasty (odds ratio = 5.1, 95% confidence interval = 1.44 to 18.11, p = .012). Type and age at palatoplasty were not significantly associated with either the rate of developing these sequelae or the rate of achieving bilaterally normal hearing and ear examinations. Conclusions Type of palatoplasty did not influence otologic and audiologic outcomes in 5- to 6-year-olds with unilateral cleft lip and palate. The potential influence of lip repair on otologic outcomes warrants further investigation.

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Eustachian Tube Function in OME Patients with Cleft Palate: Special Reference to the Prognosis of Otitis Media with Effusion

Cited by 15 publications

References 3 publications

The aetiology of otitis media with effusion: a review

The aetiology of otitis media with effusion: a review

Finite Element Analysis of Eustachian Tube Function in Cleft Palate Infants Based on Histological Reconstructions

Otologic and Audiologic Outcomes with the Furlow and von Langenbeck with Intravelar Veloplasty Palatoplasties in Unilateral Cleft Lip and Palate

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