Related Experiment Video
Updated: Jul 25, 2026
Intrathecal Application of a Fluorescent Dye for the Identification of Cerebrospinal Fluid Leaks in Cochlear Malformation
Published on: February 29, 2020
Optimal Timing for Auditory Brainstem Response After Tympanostomy Tube Placement in Children with Cleft Lip and
Koichiro Oyake1, Sei Kobayashi1, Tomotaka Shimura1
1Department of Otorhinolaryngology, Showa University Fujigaoka Hospital, Yokohama 227-8501, Japan.
Insights
Tympanostomy surgery significantly improves auditory brainstem response (ABR) results in children with cleft lip and/or palate (CLP) and otitis media with effusion (OME). Reassessing hearing on or after postoperative day 15 provides more accurate ABR findings.
Area of Science:
- Otolaryngology
- Pediatric Audiology
- Craniofacial Anomalies
Background:
- Children with cleft lip and/or palate (CLP) frequently experience otitis media with effusion (OME), leading to increased newborn hearing screening (NHS) referrals.
- Auditory brainstem response (ABR) testing in the presence of OME can inaccurately suggest sensorineural hearing loss.
Purpose of the Study:
- To evaluate newborn hearing screening (NHS) and auditory brainstem response (ABR) findings in children with CLP.
- To determine the optimal timing for ABR reassessment following tympanostomy in this population.
Main Methods:
- Retrospective review of 271 cleft lip and/or palate cases.
- Analysis of cleft type, NHS results, ABR findings, OME incidence, and tympanostomy rates.
- Comparison of pre- and post-tympanostomy ABR results and evaluation of postoperative timing for reassessment.
Main Results:
- Otitis media with effusion (OME) prevalence was 48.7%, significantly higher (73.4%) in patients with cleft palate involvement.
- Tympanostomy surgery led to significant improvements in ABR wave V thresholds (61.67 to 34.72 dBnHL) and wave I latency (2.27 to 1.76 ms).
- Postoperative ABR wave V thresholds were significantly better when reassessment occurred on or after postoperative day 15.
Conclusions:
- Tympanostomy effectively improves auditory brainstem response (ABR) outcomes in children with cleft lip and/or palate (CLP) and otitis media with effusion (OME).
- Scheduling ABR reassessment on or after postoperative day 15 can yield more accurate hearing assessments and potentially reduce parental anxiety.
Abstract:
Objective: Children with cleft lip and/or palate (CLP) commonly present with otitis media with effusion (OME), with increased referrals for newborn hearing screening (NHS). Auditory brainstem response (ABR) testing with OME may mimic sensorineural hearing loss. This study evaluated NHS and ABR findings on and optimal timing for ABR reassessment after tympanostomy in patients with CLP. Methods: We conducted a retrospective study reviewing 271 CLP cases at our institution. The data included the cleft type, NHS results, ABR findings, OME incidence, and tympanostomy rate. Subgroup analyses compared ABR results before and after tympanostomy and via postoperative timing. Statistical comparisons were performed using the Mann-Whitney U test and Fisher's exact test. Results: The NHS referral rate was 14.0%, and the OME incidence was 48.7%. These cases occurred in patients with cleft palate involvement, with an OME prevalence of 73.4%. Tympanostomy was performed in 72.6% of cases. Among 36 ears tested pre- and post-tympanostomy, wave V thresholds improved from 61.67 ± 16.08 to 34.72 ± 6.54 dBnHL (p < 0.0001), and wave I latency decreased from 2.27 ± 0.36 to 1.76 ± 0.12 ms (p < 0.0001). Postoperative wave V thresholds were significantly better in the ≥15-day group (p = 0.037), with 65% (17/26) of ears showing thresholds <40 dBnHL compared to 25% (3/12) in the <15-day group (p = 0.035). No timing-related differences were found regarding wave I latency. Conclusions: Tympanostomy significantly improved the ABR results in children with CLP and OME. Reassessment on or after postoperative day 15 may yield more accurate results and may help to reduce parental anxiety.
