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[Early treatment of middle ear disease in cleft palate infants]
1Department of Otorhinolaryngology, The Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China.
Insights
Early myringotomy with tube insertion effectively treats secretory otitis media and hearing loss in infants with cleft palate. Tympanocentesis is not recommended for routine management in these infants.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Secretory otitis media (SOM) and associated hearing loss are common in infants with cleft palate.
- Current management strategies require evaluation for efficacy in this specific population.
Purpose of the Study:
- To compare the effectiveness of myringotomy with tube insertion versus tympanocentesis in treating SOM and hearing loss in infants with cleft palate.
Main Methods:
- A comparative study involving 19 infants (38 ears) undergoing myringotomy with tube insertion and 15 infants (30 ears) undergoing tympanocentesis, all at the time of cleft lip repair.
- Auditory brainstem response (ABR) and acoustic immitance audiometry were used for assessment during a 12-month follow-up period.
Main Results:
- Myringotomy with tube insertion significantly improved ABR thresholds (55.41 to 28.48 dBnHL) and normalized tympanograms in 79.17% of cases.
- Tympanocentesis showed less improvement in ABR thresholds (40.63 to 26.50 dBnHL) with only 40.91% tympanogram normalization, and no significant long-term changes were observed.
Conclusions:
- Early myringotomy with tube insertion is an effective intervention for restoring middle ear function in cleft palate infants with SOM.
- This procedure should be considered concurrently with cleft lip repair within the first year of life.
- Tympanocentesis is not recommended as a routine management for SOM in this patient group.
Objective:
To explore the effect of myringotomy with insertion of tube and tympanocentesis on alleviating secretory otitis media (SOM) and hearing loss in cleft palate infants.
Methods:
Nineteen cleft lip and palate infants with SOM and hearing loss (38 ears) were treated with myringotomy with insertion of ventilation tube at the same time of repair of the cleft lip, who were performed averagely at 6.9 months of age. Fifteen cleft lip and palate infants with SOM (30 ears) were treated with tympanocentesis at the same time of repair of the cleft lip averagely at 6.6 months of age. All cases were followed up from 1 week to 12 months and estimated by auditory brainstem response (ABR) and acoustic immitance audiometry.
Results:
The average wave V reacting thresholds of ABR were separately 55.41 dBnHL and 28.48 dBnHL, and 79.17% tympanogram B changed to tympanogram A in cleft palate infants with insertion of tube before and after operation. The average wave V reacting thresholds of ABR were separately 40.63 dBnHL and 26.50 dBnHL, and 40.91% tympanogram B changed to tympanogram A in cleft palate infants with tympanocentesis preoperatively and in 1 week postoperatively, in whom the average hearing thresholds and tympanograms had no significant difference preoperatively and in 1 or 3 months postoperatively (P>0.05).
Conclusion:
The early myringotomy with insertion of tube is effective to restore the function of the middle ear in cleft palate infants with SOM, so to suggest to be performed at the same time of the repair of cleft lip within the first 1-year of life. The tympanocentesis should not be used as a regular management in the cleft palate infants with SOM.
