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Middle ear disease in cleft palate children at three years of age
B Rynnel-Dagöö1, K Lindberg, D Bagger-Sjöbäck
1Department of Otorhinolaryngology, Huddinge University Hospital, Sweden.
Insights
Children with cleft palate repaired at one year old showed a slight increase in acute otitis media but normal hearing in most by age 3-4. Immune function remained comparable to healthy peers.
Area of Science:
- Pediatric Otolaryngology
- Craniofacial Surgery
- Immunology
Background:
- Cleft palate is a congenital condition affecting speech and hearing.
- Middle ear disease is common in children with cleft palate.
- The role of immune function in otitis media in this population requires further investigation.
Purpose of the Study:
- To investigate aural pathology in children with cleft palate after surgical repair.
- To assess the frequency of acute and secretory otitis media.
- To evaluate antipneumococcal antibody activity in relation to middle ear disease.
Main Methods:
- Palate repair was performed at one year of age in 44 children.
- Children were investigated for aural pathology at 3 years of age.
- Specific antipneumococcal antibody activity was measured and compared to controls.
Main Results:
- 82% of children had normal hearing at 3-4 years of age.
- A slight increase in acute otitis media was observed in children without immune system immaturity.
- One third of the children experienced long-standing secretory otitis media, a higher prevalence than in the general population.
Conclusions:
- Palate repair in early childhood can lead to improved hearing outcomes.
- While acute otitis media shows a slight increase, secretory otitis media is more prevalent in cleft palate patients.
- Immune function in these children is comparable to healthy peers, suggesting other factors contribute to middle ear disease.
Abstract:
Fourty-four cleft palate children consecutively referred to a plastic surgery unit were treated with palate repair at one year of age by one surgeon. The children were not routinely treated with ventilating tubes for middle ear disease. At 3 years of age they were investigated for aural pathology. Also specific antipneumococcal antibody activity was measured and was found to be compatible with the activity found in healthy age-matched control children. In the cleft palate children with no immaturity of the immune system only a slight increase in frequency of acute otitis media was evident. One third of the children had however suffered from long-standing secretory otitis media which can be regarded to be more common than what has been found in the normal population in several epidemiologic studies. At 3-4 years of age 82% of the children had a normal hearing indicating an improvement of the condition.