Evaluation of Eustachian tube function in patients of cleft palate and effects of palatoplasty on these findings
Keywords:Cleft palate, Eustachian tube dysfunction, Tympanometry
Background: Isolated cleft palate and cleft palate and cleft lip patients have poor Eustachian tube function which results in hearing impairment that too in the speech formative years. Aim of study was to evaluate tympanometric findings in patient of cleft palate and effect of palatoplasty on both short term and long term postoperatively.
Methods: The subjects consisted of patients attending the cleft lip and palate clinic. This was a combined clinic consisting of department of plastic surgery, department of ENT and department of dental surgery held every month at a tertiary care hospital in Delhi. Study consisted of three groups of patients namely preoperative group, postoperative group and pre-postoperative group.
Results: No significant difference was observed in tympanometric abnormalities in cases of combined cleft lip and palate as compared to isolated cleft palate. After age of 5 months once changes of OME has set in there was no significant change in middle ear findings irrespective of palatal repair.
Conclusions: There is a very high prevalence of otitis media with effusion in these patients. The changes do resolve spontaneously after age of seven, this perhaps is due to combined effect, growth, development and l maturity of Eustachian tube and palatal surgery rather than palatal surgery alone.
Davis JS, Ritchie HP. Classification of congenital clefts of lip and palate. J Am Med Assoc. 1922;79(16):1323-7.
Jerger J. Clinical experience with impedance audiometry. Arch Otolaryngol. 1970;92(4):311-24.
Paradise JL, Bluestone CD. Early treatment of the universal otitis media of infants with cleft palate. Pediatrics. 1974;53(1):48-54.
Dhillon RS. Middle ear in cleft palate cases pre and post palatal closure. J R Soc Med. 1988;81(12):710-3.
Zingade ND, Sanji RR. The prevalence of otological manifestations in children with cleft palate. Indian J Otolaryngol Head Neck Surg. 2009;61(3):218-22.
Handzic-Cuk J, Cuk V, Gluhinic M, Risavi R, Stajner-Katusic S. Tympanometric findings in cleft palate patients: influence of age and cleft type. J Laryngol Otol. 2001;115(2):91-6.
Young A. The state of the ears in children with a cleft palate deformity. J Laryngol Otol. 1968;82(8):707-15.
Feniman MR, deSouza AG, Jorge JC. Otoscopic and tympanometric findings in infants with cleft lip and palate. Rev Bras Otorrinolaringol. 2008;74(2):248-52.
Smith LK, Gubbels SP, Macarthur CJ, Milczuk HA. The effect of the palatoplasty method on the frequency of ear tube placement. Arch Otolaryngol Head Neck Surg. 2008;134(10):1085-9.
Tunbiulek G, Figenozgu R, Belgiun E. Audiologic and tympanometric findings in children with cleft lip and palate. Cleft Palate Craniofac J. 2003;40(3):304-9.