Prognosis of otitis media with effusion in pediatric patients with cleft palate during language-acquisition period treated by simultaneous tympanostomy tube placement with palatoplasty

Iemura-Kashiwagi, Maho; Okano, Takayuki; Iwai, Noriko; Taniguchi, Mirei; Omori, Koichi

doi:10.1016/j.ijporl.2022.111071

Cited by 3 publications

(4 citation statements)

References 34 publications

(30 reference statements)

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“…Hearing loss has been thought to have a significant impact on children’s language and psychosocial development [ 19 ]. Therefore, the rapid and adequate treatment of hearing loss should be mandatory [ 3 ]. The overall rate of HL in our group was 40%, analogous with other retrospective studies [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, when early VTs were not inserted, there was a high risk of late VT ( p = 0.002; OR 13.6). Iemura-Kashiwagi and colleagues [ 3 ] evaluated 75 CP patients. They concluded that VT insertion at the same time as palatoplasty may reduce the number of times the patient requires general anesthesia and maintain good middle ear condition during the period of language acquisition between 1 and 3 years of age [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Iemura-Kashiwagi and colleagues [ 3 ] evaluated 75 CP patients. They concluded that VT insertion at the same time as palatoplasty may reduce the number of times the patient requires general anesthesia and maintain good middle ear condition during the period of language acquisition between 1 and 3 years of age [ 3 ]. According to a retrospective study on 97 CLP patients conducted by Klockars et al [ 8 ], early tympanostomy tube placement should always be considered; VT combined with early soft palate closure (at four months of age) reduced the frequency of OME [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cleft lip and palate (CLP) in children is frequently complicated by otitis media with effusion (OME), an accumulation of fluid within the middle ear, due to Eustachian tube dysfunction, with an incidence ranging from 74.3% to around 90% in various reports [ 1 , 2 ]. The sequelae of OME also include perforation, adhesion, and retraction of the tympanic membrane, as well as chronic changes such as myringosclerosis or tympanosclerosis [ 3 ]. These changes can lead to mild or moderate hearing impairment that may be permanent later in life, especially for the high frequencies that are critical for speech recognition [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hearing Status and Ventilation Tube at Time of Palatoplasty in Cleft Lip and Palate Patients: A Retrospective Study

Frisina¹,

Piacentile

Frosolini

et al. 2023

Medicina

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Background and Objectives: There is no consensus regarding the indications for and timing of ventilation tube (VT) insertion in cleft lip and palate (CLP) patients. Our aim was to search for clinical and surgical (i.e., VT insertion) characteristics that influence the hearing status in CLP. Materials and Methods: We reviewed the hearing outcome of consecutive CLP cases operated on at a single referral center. Univariate and multivariate analysis were applied as appropriate. Results: We included 285 consecutive CLP patients, 109 female and 176 male; the mean age at last follow-up was 16.2 years. Unilateral CLP was found in 249 cases and bilateral CLP in 36. Early VTs (i.e., at the time of hard palate surgery) were applied in 75 (26.3%) patients. Late VTs (i.e., after hard palate surgery during follow-up) were applied in 69 (24.2%) children, at a mean age of 6.7 years old. Hearing loss (pure-tone average > 20 dB) was found in 114 (40%) CLP patients at last available follow-up (mild hearing loss in 96 patients, moderate in 18). In univariate and multivariate analyses, we found that only the absence of early VT insertion (p = 0.0003; OR = 18.2) was an independent prognostic factor of hearing loss in CLP patients. Furthermore, when early VTs were not inserted, there was a high risk of late VT (p = 0.002; OR 13.6). Conclusions: According to our results, the absence of VT insertion at the time of hard palate surgery is an independent prognostic risk factor of hearing loss in CLP patients. Early VT placement in CLP patients may prevent hearing loss and related consequences. These findings should be tested in a large, randomized clinical trial.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%