Hearing outcomes in children with cleft palate and referred newborn hearing screen

Jordan, Victoria A.; Sidman, James D.

doi:10.1002/lary.24727

Cited by 15 publications

(15 citation statements)

References 10 publications

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“…We found that 30.1% of patients failed the NBHS, even after excluding patients who were eventually diagnosed with sensorineural hearing loss (SNHL). This is slightly greater than the 11% to 28% incidence cited in previous studies 24-26 and much greater than the 1.6% incidence of failure in the general population. 27 Middle ear status of children with cleft palate worsens during the first months of life.…”

Section: Discussioncontrasting

confidence: 56%

The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate

Shaffer

Ford

Choi

et al. 2017

Otolaryngol.--head neck surg.

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Objective Describe the impact of hearing loss, tympanostomy tube placement before palatoplasty, and number of tubes received on speech outcomes in children with cleft palate. Study Design Case series with chart review. Setting Tertiary care children's hospital. Subjects and Methods Records from 737 children born between April 2005 and April 2015 who underwent palatoplasty at a tertiary children's hospital were reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, sensorineural or mixed hearing loss, no tubes, first tubes after palatoplasty, or first clinic after 12 months of age. Data from 152 patients with isolated cleft palate and 166 patients with cleft lip and palate were analyzed using Wilcoxon rank-sum, χ, and Fisher exact test and logistic regression. Results Most patients (242, 76.1%) received tubes before palatoplasty. Hearing loss after tubes, but not before, was associated with speech/language delays at 24 months ( P = .005) and language delays ( P = .048) and speech sound production disorders (SSPDs, P = .040) at 5 years. Receiving tubes before palatoplasty was associated with failed newborn hearing screen ( P = .001) and younger age at first posttubes type B tympanogram with normal canal volume ( P = .015). Hearing loss after tubes ( P = .021), language delays ( P = .025), SSPDs ( P = .003), and velopharyngeal insufficiency ( P = .032) at 5 years and speech surgery ( P = .022) were associated with more tubes. Conclusion Continued middle ear disease, reflected by hearing loss and multiple tubes, may impair speech and language development. Inserting tubes before palatoplasty did not mitigate these impairments better than later tube placement.

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Section: Discussioncontrasting

confidence: 56%

The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate

Shaffer

Ford

Choi

et al. 2017

Otolaryngol.--head neck surg.

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“…These conditions include malocclusion (82%), serous otitis media (71%), dysphonia due to hypernasality (37%), postoperative feeding disorder (21%), and hearing loss (7%), indicating the necessity of long-term management involving a multidisciplinary approach. [ 4 , 14 , 16 – 19 ] With regards to the long-term physical development of patients with cleft lip and cleft palate, Prahl et al performed physical measurements of CLP patients at 14 months of age and found that the z-scores for body weight and height were -0.72±0.77 and -0.37±0.78, respectively. [ 20 ] Their results, similar to the present study findings, showed that the patients maintained physical development that is similar to that of the general population.…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic Research on Malformations Associated with Cleft Lip and Cleft Palate in Japan

et al. 2016

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To investigate malformations associated with cleft lip and cleft palate, we conducted surveys at neonatal intensive care units (NICUs) and other non-NICU facilities and to determine whether there are differences among facilities. The regional survey investigated NICU facilities located in Oita Prefecture, including 92 patients with cleft lip and palate (CLP) or cleft palate (CP) that occurred between 2004 and 2013, and the national survey investigated oral surgery, plastic surgery, and obstetrics and gynecology facilities located in Japan, including 16,452 patients with cleft lip (CL), CLP, or CP that occurred since 2000. The incidence per 10,000 births was 4.2, 6.2, and 2.8 for CL, CLP, and CP, respectively, according to the national survey, and 6.3 and 2.9 for CLP and CP, respectively according to the regional survey. These results indicated comparable incidences between the two surveys. In contrast, when the survey results on malformations associated with CLP and CP according to the ICD-10 classification were compared between the national survey conducted at oral surgery or plastic surgery facilities and the regional survey conducted at NICU facilities, the occurrence of associated malformations was 19.8% vs. 41.3% for any types of associated malformation, 6.8% vs. 21.7% for congenital heart disease, and 0.5% vs. 16.3% for chromosomal abnormalities. These results indicated that the incidences of all of these associated malformations were significantly greater in the survey conducted at NICU facilities and similar to the findings from international epidemiological surveys. When comparing the survey conducted at obstetrics facilities vs. NICU facilities, the occurrence of associated malformations was similar results as above. The incidence of CLP and CP was not different between surveys conducted at NICU facilities vs. non-NICU facilities; however, when conducting surveys on associated malformations, it is possible to obtain accurate epidemiological data by investigating NICU facilities where detailed examinations are thoroughly performed.

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“…The first, a retrospective cohort study of 340 infants referred through UNHS in the Netherlands, reported CHL as 'genetic' if the child had a syndrome associated with CHL, such as craniofacial anomalies or if the loss was associated with causes other than OM [29]. The second study conducted by Jordan and Sidman [55] reported CHL as a 'permanent hearing loss' on point of referral for hearing aid fitting. However, this study relied on aABR testing for identification of hearing loss, which may over represent the incidence of hearing loss in this cohort as this is a screening, as opposed to a diagnostic, tool.…”

Section: Are There Any Sub-classifications Of Chl Applied Within Unhs Programs?mentioning

confidence: 99%

“…In Group 1, case history was reported in only one study [23] and otoscopy was not reported in any of the studies. Tympanometry was reported in four of the studies [24,29,[55][56]. Two studies stated that 1000-Hz tympanometry [24,56] was used.…”

Section: How Is Chl Assessed and What Onward Referrals Are Made Within Unhs Programs?mentioning

confidence: 99%

Conductive Hearing Loss Within Universal Newborn Hearing Screening Programs: A Systematic Review

Collins¹,

Beswick²,

Driscoll³

et al. 2019

J Hear Sci

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Background: Universal Newborn Hearing Screening (UNHS) attempts to identify children with a permanent, bilateral, moderate or greater hearing loss at birth. However, children who are referred from UNHS programs may have conductive hearing loss (CHL), sensorineural, or mixed hearing loss. The aim of this review was to investigate the prevalence, sub-classifications, audiological diagnosis, and medical management of CHL within UNHS programs. Material and methods:A systematic literature search was completed in the scientific databases PubMed, CINAHL, and Embase. Studies were reviewed with reference to the inclusion criteria, then graded to assess the internal and external validity, leaving 25 studies for review. Results:The prevalence of conductive hearing loss ranged from 0.4% to 64.5%. 'Genetic' and 'Permanent' were the only two sub-classifications of CHL identified, with no uniform terminology evident. Given CHL is not a target condition of UNHS, audiological assessment was consistent with the diagnosis of Permanent Childhood Hearing Loss (PCHL). There was little evidence of audiological review, onward referrals, or medical management for CHL within UNHS programs. Of the evidence obtained, no alternative pathway was found for children identified with CHL through UNHS. Conclusions:In view of the limited evidence for CHL within UNHS, further investigation into the prevalence, sub-classification, and appropriate management of CHL within a UNHS program is recommended to better guide evidence-based assessment and management of these children.

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Hearing outcomes in children with cleft palate and referred newborn hearing screen

Abstract: Newborns with cleft palate who refer their universal newborn hearing screen could postpone diagnostic hearing testing until after placement of pressure equalization tubes, unless there is a clue to permanent hearing loss such as a comorbid condition.

Cited by 15 publications

References 10 publications

The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate

The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate

Epidemiologic Research on Malformations Associated with Cleft Lip and Cleft Palate in Japan

Conductive Hearing Loss Within Universal Newborn Hearing Screening Programs: A Systematic Review

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