Related Experiment Video
Updated: Apr 27, 2026
Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
Cartilage tympanoplasty in children with cleft palate repair
Aaron M Metrailer1, Matthew D Cox, Jumin Sunde
1*Department of Otolaryngology/Head and Neck Surgery, University of Arkansas for Medical Sciences; †Arkansas Children's Hospital; and ‡Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, U.S.A.
Insights
Type 1 cartilage tympanoplasty in pediatric cleft palate patients yields comparable hearing results to non-cleft patients. This surgical technique effectively addresses middle ear issues in this specific population.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Middle ear disease is common in pediatric patients with cleft palate.
- Cartilage tympanoplasty is a surgical option for chronic otitis media with or without tympanic membrane perforation.
Purpose of the Study:
- To evaluate the outcomes of type 1 cartilage tympanoplasty in pediatric patients with a history of cleft palate repair.
- To compare these outcomes with a historical control group of non-cleft palate patients.
Main Methods:
- Retrospective chart review of 37 pediatric patients (45 ears) with repaired cleft palate undergoing type 1 cartilage tympanoplasty.
- Comparison with a previously published historical control group of non-cleft palate patients undergoing the same procedure.
- Collection of data on demographics, cleft type, surgical indications, middle ear status, complications, and auditory outcomes.
Main Results:
- Patients with cleft palate had worse preoperative hearing levels than non-cleft patients.
- Despite worse preoperative hearing, type 1 cartilage tympanoplasty achieved comparable postoperative hearing results between the two groups.
- Graft failure requiring revision surgery was similar between groups; secondary tympanostomy tube insertion was slightly higher in the cleft palate group.
Conclusions:
- Type 1 cartilage tympanoplasty is effective in pediatric patients with a history of cleft palate.
- The procedure achieves comparable closure and hearing outcomes to those in patients without cleft palate anomalies.
Objective:
To determine outcomes of type 1 cartilage tympanoplasty in a cohort of pediatric patients with a history of cleft palate repair.
Patients And Outcome Measures:
Retrospective chart review and comparison with a historical control group of patients with no cleft palate anomaly undergoing the same procedure by the same surgeon at a tertiary care pediatric hospital. A total of 37 patients between ages 4 and 19 years inclusive (45 ears), with a history of repaired cleft palate, underwent type 1 cartilage tympanoplasty with or without primary tube insertion from September 2004 to October 2012. Demographics, type of cleft palate, surgical indication, middle ear status, complications, history of myringotomy tube insertion, and auditory outcomes were collected. Results were compared with those for a non-cleft palate cohort that had undergone the same procedure, which had been previously published.
Results:
The unadjusted average preoperative and postoperative pure-tone averages for patients with a history of cleft palate were 22.06 and 7.29, respectively, compared with 18.34 and 8.32, respectively, for non-cleft patients. Despite significantly worse preoperative hearing levels among the cleft palate group, there was no statistically significant difference in outcomes with regard to hearing results between the two groups. One patient in the cleft palate group required revision type 1 cartilage tympanoplasty for graft failure, which is comparable to that reported for non-cleft palate patients. Post-tympanoplasty secondary tympanostomy intubation was slightly higher for the cleft palate population.
Conclusion:
Type 1 cartilage tympanoplasty, when performed in a pediatric population with a history of cleft palate, can achieve closure and hearing results that are comparable of those in patients with no such anomaly.
