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Middle Ear Status in Cleft Lip and Palate Patients: A Five-Year Follow-Up
Fatemeh Mirashrafi1, Hamed Emami2, Zeinab Bagheri2
1Otorhinolaryngology Research Center, Otorhinolaryngology Head and Neck Surgery Department, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Otitis media with effusion in cleft palate patients often resolves with age. Palatoplasty timing and ventilation tube frequency did not significantly impact long-term middle ear outcomes in this study.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Genetics and Developmental Biology
Background:
- Otitis media with effusion (OME) is a common complication in children with cleft lip and palate (CLP).
- Optimal management strategies for OME in CLP patients remain debated.
- Long-term otologic outcomes following surgical repair require further evaluation.
Purpose of the Study:
- To assess the otologic outcomes in children with cleft lip/palate at least five years after palatoplasty.
- To identify potential prognostic factors influencing middle ear status post-surgery.
Main Methods:
- Retrospective study of 40 children undergoing palatoplasty using Sommerlad's Technique.
- Data collected included age, gender, cleft type, palatoplasty date, and ventilation tube (VT) insertion details.
- Otomicroscopy, middle ear status, and tympanometry were evaluated five years postoperatively.
Main Results:
- No significant difference in middle ear status between complete and incomplete cleft palates.
- Older age at study and longer follow-up correlated with normal middle ear status.
- Palatoplasty timing and VT insertion frequency showed no significant impact on middle ear status.
Conclusions:
- Middle ear status generally improves with age in pediatric patients with cleft palate.
- Age at palatoplasty and VT insertion frequency were not significant predictors of long-term otologic outcomes in this cohort.
- Intervelar veloplasty under magnification appears to yield consistent results regarding middle ear status long-term.
Introduction:
The best strategy to treat otitis media with effusion in cleft lip/palate patients is still under debate. This research aimed to evaluate the otologic outcomes in children at least five years post-repair.
Materials And Methods:
A retrospective study was conducted on 40 children who underwent palatoplasty between January 1, 2012, and January 1, 2014, at Children's Medical Center (Tehran, Iran). Patients had intervelar veloplasty under magnification (Sommerlad's Technique). Based on patients' charts, their age, gender, cleft type, date of palatoplasty, as well as the date and the frequency of ventilation tube (VT) insertion, were recorded. Furthermore, otomicroscopy, middle ear status, and tympanometry were assessed five years postoperatively.
Results:
There was no significant difference in middle ear status between children with complete and incomplete cleft palates. The mean age at the time of study and the mean follow-up duration were significantly higher in the normal middle ear group, compared to the abnormal middle ear group (7.7±1.6 vs. 6.8±0.9, P=0.03 and 6±1.15 vs. 5.42±0.9, P=0.04, respectively). Middle ear status was not significantly different between early or late palatoplasty patients. In addition, the frequency and timing of VT insertion were not significantly different between the two groups.
Conclusions:
Middle ear status improved as patients grew older; however, the age of palatoplasty and the frequency of VT insertion were not significant prognostic factors in patients who underwent intervelar veloplasty under magnification.
