Sequelae of otitis media with effusion among children with cleft lip and/or cleft palate1

Abstract

Otitis media with effusion (OME) is common among children with cleft palate, and may lead to such long-term consequences as hearing loss, tympanic membrane retraction, and chronic otitis media (COM). In total, 104 children with cleft lip and/or palate treated for OME at our institution were reviewed. Mean duration of follow-up was 6.9 years, and mean age at latest follow-up was 9.6 years. The incidence of COM was 19%, and the incidence of cholesteatoma was 1.9%. Ears showing such long-term sequelae of OME as hearing loss, tympanic membrane retraction, and chronic otitis media, were noted to have undergone a significantly greater number of ventilation tube insertions than ears not showing these sequalae. Our findings would suggest that a conservative approach to the management of OME in children with cleft palate is more likely to be beneficial in the long term.

The prevalence of otological manifestations in children with cleft palate

“…This is in agreement with the fi ndings of other investigators [3,4,23]. This suggests that Eustachian tube dysfunction, palatine muscle abnormalities and other problems may occur irrespective of the type or side of cleft.…”

“…There was no history of hearing problems obtained from the parents of the participants. Previous studies have documented the absence of clinically signifi cant hearing loss in children with cleft [13][14][15]. Some investigators have, however, commented on varying degrees of hearing loss found in children with cleft palate [4,12,16].…”

“…Despite having a well documented relationship of cleft palate with middle ear effusion [1][2][3], little data exists regarding otopathology in Indian children with cleft palate. We had noticed clinically a high number of children with non-syndromic cleft palate having external ear abnormalities.…”

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

“…Children with CLP may suffer recurrent or continuous OME, causing atelectasis, ossicular fixation, and tympanosclerosis [2,16,17], which can result in conductive hearing loss of up to 30 decibels (dB). Researchers have previously shown that, regardless of whether they have undergone cleft palate repair surgery, as many as 90% of children with CLP suffer from OME or conductive hearing loss, while 50% suffer from recurrent otitis media [2,5,[18][19][20].…”

“…Hearing outcomes were evaluated in several case-series studies [16,23,43,[53][54][55][56][57]. Over the long term, between 50 and 94% of CLP children recovered normal hearing after being administered VTI in conjunction with palatoplasty (follow-up 5.5-15.4 years) [16,43,[54][55][56][57].…”