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Audiological profile in older children and adolescents with unrepaired cleft palate
Yamani Venkata Ramana1, Vipul Nanda, Gautam Biswas
1Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab, India.
Insights
Children and adolescents with unrepaired cleft palate often have mild to moderate hearing loss. Further research is needed to determine the best treatment for otitis media with effusion in this population.
Area of Science:
- Otolaryngology
- Pediatric Audiology
Background:
- Cleft palate is a congenital condition that can affect hearing.
- Otitis media with effusion (OME) is common in children with cleft palate.
Purpose of the Study:
- To investigate the audiological profile of children and adolescents with unrepaired cleft palate.
- To establish a consensus on managing OME in this specific patient group.
Main Methods:
- A prospective study was conducted on patients over 7 years old with unrepaired cleft palate.
- Audiological assessments included otoscopy, pure tone audiometry, and impedance audiometry.
Main Results:
- Most patients (86.7%) were asymptomatic.
- Mild tympanic membrane retraction was observed in 50% of ears.
- Type B tympanometric curves and mild to moderate hearing impairment (mean 27.11 dB) were prevalent.
Conclusions:
- Unrepaired cleft palate is associated with hearing impairment in children and adolescents.
- The optimal management strategy for OME in this population requires further investigation, comparing conservative versus aggressive surgical approaches.
Objective:
To study the audiological profile in the cleft population comprising older children and adolescents with unrepaired cleft palate and to arrive at a consensus regarding management of otitis media with effusion in this unique group.
Setting:
Tertiary care institute in Chandigarh, Punjab, India.
Design:
Prospective study based on all patients older than 7 years with unrepaired cleft palate, attending the plastic surgery outpatient department, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India, from January 2001 to December 2002. Patients with submucous cleft were excluded from the study. General characteristics, otoscopic findings, pure tone audiometry, and impedence audiometry of all patients were recorded.
Results:
Patients' ages ranged from 8 to 18 years, with a mean of 10.5 years. Regarding otological complaints, 86.7% were asymptomatic. Otoscopic findings revealed mild retraction as the most common finding in 50% of the ears. Type B curve was the most common tympanometric finding. The highest and lowest hearing thresholds recorded were 45 db and 15 db, respectively, with a mean of 27.11 db.
Conclusion:
The audiological profile of this unique group, which neither had undergone palatoplasty nor had received treatment for the ear condition, demonstrates a mild to moderate hearing impairment. This definitely requires treatment, but owing to the lack of a prospective control group, it is difficult to conclude whether these patients are benefited by conservative treatment alone or by an early aggressive surgical treatment for otitis media with effusion (OME).
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