Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate

Ungkanont, Kitirat; Boonyabut, Panrasee; Komoltri, Chulaluk; Tanphaichitr, Archwin; Vathanophas, Vannipa

doi:10.1177/1055665617730361

Cited by 14 publications

(16 citation statements)

References 22 publications

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“…5 In fact, more than 80% of patients with cleft deformity show pathologies of the middle ear in the first 2 years of their lives. [6][7][8][9] Middle ear effusion results in reduced sound perception and adversely influences speech and language development. 10 The first 12 months of life are particularly important for language acquisition and processing.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Tympanostomy Tube Placement in Relation to Cleft Width and Type

et al. 2021

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Objectives/Hypothesis: The prevalence of tympanostomy tube surgery (TTS) in patients with a cleft deformity was investigated, in relation to cleft width and cleft type.Study Design: Retrospective review of medical health records. Methods: Retrospective review of medical health records. Seventy-eight patients with non-syndromic cleft deformity of the palate and/or alveolus and lip between 2003 and 2017 were investigated. All available medical documents were analyzed. The study group was divided into subgroups: 1) patients with isolated cleft palate (CP) and patients with a cleft palate with cleft lip and alveolus (CLP). 2) According to Veau's classification (I-IV), further subgroups were defined. Cleft width was measured using plaster cast models.Results: TTS was performed in 55% of the patients (n = 43). Considering Veau's classification, TTS was conducted as follows: Veau I 65.2% (n = 15/23), Veau II 55.0% (n = 11/20), Veau III 47.6% (n = 10/21), and Veau IV 50.0% (n = 7/14). Cleft classifications, maxillary arch width, and absolute/relative cleft width had no statistical impact on TTS occurrence. Although no significant correlation could be found, patients in our study group with CP (Veau I and II) underwent TTS more often (60.5%, n = 26/43) than patients with CPL (Veau III and IV; 48.6%, n = 17/35) during a three-year follow-up.Conclusion: None of the cleft characteristics examined had a significant impact on the proportion of patients who received TTS. Nevertheless, patients with lower Veau classification and CP received tympanostomy tubes more often. Therefore, otolaryngologists and pediatricians treating children with cleft palate should maintain a high level of suspicion for chronic middle ear effusion, even in patients with small clefts.

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Section: Introductionmentioning

confidence: 99%

Prevalence of Tympanostomy Tube Placement in Relation to Cleft Width and Type

et al. 2021

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“…12 Hearing loss from OME may add more severity to any speech defect that already exists from cleft palate. In our previous study, 13 we found that the cumulative incidence of OME in children with cleft palate was 53.7% at 12 months of age and 81.1% when the children reached 24 months old. Chronic middle Original Article SMJ ear effusion and frequent recurrences are characteristic of OME in children with cleft palate.…”

Section: Discussionmentioning

confidence: 77%

Long-term Outcome of the Management of Otitis Media with Effusion in Children with and Without Cleft Palate Using the House-brand Polyethylene Ventilation Tube Insertion

Ungkanont

2021

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Objective: To study the long-term outcome of otitis media with effusion in children with and without cleft palate treated with the same protocol of ventilation tube insertion. Materials and Methods: A retrospective cohort study was conducted in eighty-five children with cleft palate and 80 children without cleft palate who had otitis media with effusion and had follow-up between 2001 and 2019. Both groups were treated with ventilation tube insertion for longstanding middle ear effusion more than 90 days. The main outcome was the cumulative incidence of surgical management, time of the indwelling ventilation tubes, conditions of the tympanic membrane, and the hearing outcome. Results: At 24 months old, 63.5% of children with cleft palate and 11.3% of children without cleft palate had their first ventilation tube insertion. Repeated surgery was done in 81.2% of children with cleft palate and 50% of children without cleft palate (p < 0.001). The median duration of the indwelling tube was 11.3 months in the children with cleft palate and 12.4 months in the non-cleft children (p = 0.82). At the end of the study, 63.7% of children without cleft palate and 43.5% of children with cleft palate had normal tympanic membrane (p = 0.009). The hearing outcomes of children with and without cleft palate were 20.7 dB and 19.3 dB, respectively. Conclusion: Children with and without cleft palate were managed under the same guideline and the hearing outcome was favorable in both groups.

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“…In our hospital, the prevalence of OME was reported by Ungkanont et al to be around 50%-80%. 33 They also found a significant improvement in the audiograms after palatoplasty. In this series, we found 75% of patients had OME.…”

Section: Discussionmentioning

confidence: 91%

Speech Outcome Analysis after Primary Cleft Palate Repair: Interim Siriraj Hospital Audit

et al. 2021

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Objective: To evaluate the speech outcomes after primary cleft palate repair in a single tertiary medical institution of Thailand.Materials and Methods: A prospective cohort study was performed. Patients who had cleft palate with/without cleft lip and underwent primary cleft palate repair were included. Speech assessment was performed using the Pittsburgh weighted speech score (PWSS) by a speech-language pathologist.Results: Forty patients (21 males and 19 females) who underwent primary cleft palate repair at Siriraj Hospital were included. The median age at the time of speech evaluation was 7 years. The median age at primary cleft palate surgery was 12 months. The predominant cleft palate type was Veau 3 (47.5%). Oronasal fistula occurred 40%. Two-flap palatoplasty and intravelar veloplasty were the most common procedures. Median PWSS was 7, in which the competence velopharyngeal mechanism was found 5%, borderline competence 10%, borderline incompetence 32.5%, and incompetence velopharyngeal mechanism 52.5%. Among the velopharyngeal incompetence group, articulation disorder was the most common disorder with median score of 3. Besides, the median scores for hypo/hyper-nasality, nasal emission, phonation, and facial grimace disorder were 1, 2, 0 and 0, respectively. There was no statistically significant association between velopharyngeal incompetence and cleft types, age at primary surgery, type of operation, the width of cleft palate and prevalence of postoperative oronasal fistula or otitis media effusion.Conclusion: Velopharyngeal incompetence has been commonly identified after cleft palate repair in our institute. The articulation disorder is the most common characteristic.

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Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate

Abstract: Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

Cited by 14 publications

References 22 publications

Prevalence of Tympanostomy Tube Placement in Relation to Cleft Width and Type

Prevalence of Tympanostomy Tube Placement in Relation to Cleft Width and Type

Long-term Outcome of the Management of Otitis Media with Effusion in Children with and Without Cleft Palate Using the House-brand Polyethylene Ventilation Tube Insertion

Speech Outcome Analysis after Primary Cleft Palate Repair: Interim Siriraj Hospital Audit

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