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Eustachian tube function in cleft palate children.

W J Doyle, E I Cantekin, C D Bluestone

    The Annals of Otology, Rhinology & Laryngology. Supplement
    |May 1, 1980
    PubMed
    Summary
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    Children with cleft palates struggle to open their eustachian tubes (ET) actively, leading to severe functional obstruction and chronic otitis media with effusion (OME). This inability impairs middle ear pressure regulation.

    Area of Science:

    • Otolaryngology
    • Pediatric Health
    • Craniofacial Anomalies

    Background:

    • Cleft palate is associated with a high incidence of chronic otitis media with effusion (OME).
    • The underlying cause is suspected to be functional obstruction of the eustachian tube (ET).

    Purpose of the Study:

    • To investigate eustachian tube (ET) function in children and adolescents with cleft palates.
    • To determine the relationship between ET dysfunction and the pathogenesis of otitis media with effusion (OME).

    Main Methods:

    • Evaluated ET function using forced-response and inflation-deflation tests in 41 cleft palate patients.
    • Assessed pressure equilibration via Valsalva and Toynbee maneuvers.
    • Measured passive ET airflow resistance and resistance changes during swallowing.

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    Main Results:

    • Cleft palate patients showed impaired active ET opening during swallowing, failing to equilibrate pressures.
    • ET airflow resistance increased with swallowing in 73% of cases, indicating constriction.
    • The efficiency of ET dilation was significantly lower compared to a control group.

    Conclusions:

    • Children with cleft palates exhibit severe functional ET obstruction, primarily due to impaired tensor veli palatini (TVP) muscle function.
    • This dysfunction is the likely primary factor in the development of OME in this population.
    • ET function was not significantly influenced by age, sex, or cleft type.