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Audiological Alterations in Patients With Cleft Palate
Ramiro Adrian Rivelli1, Vanesa Casadio1, Ricardo D Bennun1,2,3
1ENT, Speech Therapy and Plastic Surgery, Asociacion PIEL.
The Journal of Craniofacial Surgery
|July 21, 2018
Summary
T tubes are the best option for ventilation during cleft palate repair, significantly reducing postoperative hearing loss. Early implantation improves middle ear ventilation, crucial for speech development in children with clefts.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Speech Pathology
Background:
- Chronic otitis media with effusion (OME) frequently affects cleft palate patients due to Eustachian tube dysfunction.
- Conductive hearing loss in these patients results from anatomical abnormalities and surgical repair of the palate.
Purpose of the Study:
- To evaluate the effectiveness of ventilation tubes in managing hearing loss in cleft palate patients.
- To compare the outcomes of different types of ventilation tubes in the postoperative period.
Main Methods:
- A cohort study compared four groups of cleft palate patients (ICL, UCLP, BCLP, ICP) undergoing palate repair between 2015-2017.
- Ventilation tubes were placed during palate repair surgery (average age 10 months).
- Postoperative hearing loss, tube type, recurrences, and complications were assessed.
Main Results:
- OME requiring ventilation tubes was diagnosed in a high percentage of patients across all cleft types.
- Patients with T tubes experienced significantly less average hearing loss (14.2 db) compared to those with diabolos (19.4 db) (P<0.05).
Conclusions:
- Early implantation of trans tympanic tubes during cleft palate repair aids middle ear ventilation.
- T tubes are recommended for optimal short-term middle ear ventilation and hearing improvement in cleft palate patients.
- Improved hearing before language acquisition is vital for proper speech development.
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