Retrospective analysis of tympanoplasty in children with cleft palate: A 24-year experience. II. Cholesteatomatous cases

Kopcsányi, Gábor; Vincze, Olga; Bagdán, Viktor; Pytel, József

doi:10.1016/j.ijporl.2015.02.020

Cited by 6 publications

(12 citation statements)

References 29 publications

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“…Five studies reported preoperative ABG, 28,43,46,50,51 and 6 studies reported postoperative ABG for patients with cleft palate repair and controls. 28,29,43,46,50,51 There was not a statistically significant mean difference between these groups for preoperative ABG (1.3 dB [95% CI, 23.3 to 5.9]; P = .570) and postoperative ABG (0.4 dB [95% CI, 22.3 to 3.2]; P = .770; Figure 7).…”

Section: Hearing Outcomesmentioning

confidence: 99%

Outcomes of Tympanoplasty After Cleft Palate Repair: A Systematic Review and Meta‐analysis

Poupore

Smaily

Carroll

et al. 2022

Otolaryngol.--head neck surg.

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Objective To analyze graft success rates and hearing outcomes in patients with a history of cleft palate (CP) repair undergoing tympanoplasty. Data Sources PubMed, Scopus, and CINAHL. Review Methods Per PRISMA guidelines, the databases were searched from date of inception through December 14, 2021. Studies of patients with previous CP repair who underwent tympanoplasty were included. Meta-analysis of proportions, continuous measures, odds ratios (ORs), and meta-regression were used to analyze graft success and hearing outcomes after tympanoplasty. Results A total of 323 patients with CP repair and 1169 controls were included. The proportion of graft success was 86.7% (95% CI, 76.1%-94.5%) in patients with CP repair and 88.8% (95% CI, 76.9-96.8) in controls. There was no difference in odds of graft success between patients with CP repair and controls (OR, 1.0 [95% CI, 0.5-1.8]; P = .870). Age was not a significant moderator of graft success in patients with CP repair ( r = 0.1 [95% CI, −0.2 to 0.3]; P = .689) or controls ( r = −0.0 [95% CI, −0.1 to 0.1]; P = .952). Comparing mean differences between pre- and postoperative air-bone gap was not statistically significant in patients with CP repair and controls (0.2 dB [95% CI, −3.1 to 3.4]; P = .930). Odds of functional success (postoperative air-bone gap <20 dB) were not different between the groups (OR, 0.8 [95% CI, 0.5-1.4]; P = .450). Conclusion This meta-analysis does not endorse anatomic or functional differences between patients with CP repair and controls after tympanoplasty. However, there is a paucity of evidence for younger children. Further studies are warranted to elucidate specific risk factors for tympanoplasty outcomes in young patients with previous CP repair.

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Section: Hearing Outcomesmentioning

confidence: 99%

Outcomes of Tympanoplasty After Cleft Palate Repair: A Systematic Review and Meta‐analysis

Poupore

Smaily

Carroll

et al. 2022

Otolaryngol.--head neck surg.

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“…Pediatric cholesteatoma is known to be more aggressive than cholesteatoma acquired later in age [1]. The incidence of recidivist disease in pediatric cholesteatoma is much higher than in adult patients [2].…”

Section: Introductionmentioning

confidence: 99%

“…This is attributed to poor Eustachian tube function due to poor development and insertion of the tensor veli palatini muscle [5,6]. Kopcs anyi et al [1] reported recidivist disease in 40% of the pediatric cleft palate patients but no significant difference compared to recidivist rate of non-cleft palate children undergoing a second look surgery.…”

Section: Introductionmentioning

confidence: 99%

Utility of vestibular testing and new technologies in a complex cholesteatoma

Chiarovano

Cheng

Mukherjee

2017

Acta Oto-Laryngologica Case Reports

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This paper reports a patient with a large recidivist cholesteatoma who underwent audio-vestibular tests and used customized 3D technologies (3D printing, augmented reality, virtual reality) to understand risks of the surgery. The patient was extremely concerned with her clinical findings and it found difficult to understand them. Customized 3D models helped the patient to understand the spatial relations and possible complications of surgery. The benefits of using new technologies in preoperative surgical planning for the surgeon and patient are also explained in a setting when radiological findings indicate high risks for surgery. Computed tomography scan showed a posterior semicircular canal fistula, which would add a significant challenge to the surgery. The fistula was not found in the result of the physiological test (cervical vestibular evoked myogenic potentials) and not found intra-operatively. Application of modern audio-vestibular investigations and use of customized 3D technologies may prove useful aids.

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“…Syndromes where a diagnosis of cholesteatoma has been a reported finding include Turner Syndrome [10][11][12], Treacher Collins Syndrome [13], Down Syndrome [14][15][16][17] and Focal Dermal Hypoplasia [18]. Numerous reports of patients presenting with cleft palate and cholesteatoma [19][20][21][22][23][24][25] have been presented with the rate of incidence approaching 6% in that population [23]. When compared to children who did not develop a cleft palate, those with a cleft palate face a 100-200 times greater likelihood of developing a cholesteatoma [23,25].…”

Section: Introductionmentioning

confidence: 99%

Cholesteatoma Pearls: Practical Points and Update

Castle¹

2018

Head and Neck Pathol

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The European Academy of Otology and Neurotology in collaboration with the Japanese Otological Society (EAONO/JOS) recently produced a joint consensus document outlining the definitions, classification and staging of middle ear cholesteatoma. The goals were to provide terminologies in the description of cholesteatoma, classify cholesteatoma into distinct categories to facilitate the comparison of surgical outcomes and to provide a staging system that reflects the severity, difficulty of complete removal and restoration of normal function. Cholesteatoma is considered a benign, expanding and destructive epithelial lesion of the temporal bone that is the result of a multifactorial process. If undetected and left treated, cholesteatoma may lead to significant complications including hearing loss, temporal bone destruction and cranial invasion. Recent advances in imaging modalities have allowed for high sensitivity and specificity in identifying the presence of cholesteatoma. Despite these advances, deficiencies exist around the world with access to health care facilities meaning cholesteatoma remains a serious and challenging entity to manage whether found within the pediatric or adult population. Proper diagnosis and management of each form of cholesteatoma is achieved by a thorough understanding of the etiology, classification, clinical presentation and histology, thereby facilitating prevention, early detection and appropriate treatment.

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Retrospective analysis of tympanoplasty in children with cleft palate: A 24-year experience. II. Cholesteatomatous cases

Cited by 6 publications

References 29 publications

Outcomes of Tympanoplasty After Cleft Palate Repair: A Systematic Review and Meta‐analysis

Outcomes of Tympanoplasty After Cleft Palate Repair: A Systematic Review and Meta‐analysis

Utility of vestibular testing and new technologies in a complex cholesteatoma

Cholesteatoma Pearls: Practical Points and Update

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