Hostname: page-component-848d4c4894-pftt2 Total loading time: 0 Render date: 2024-05-29T12:59:58.627Z Has data issue: false hasContentIssue false
  • English
  • Français

Cleft palate and ventilation tubes: a prophylactic dilemma

Published online by Cambridge University Press:  25 May 2022

A Machado Open the ORCID record for A Machado [Opens in a new window] ,
M Santos Open the ORCID record for M Santos [Opens in a new window] ,
B Leitao ,
A Silva  and
M Coutinho
A Machado*
Affiliation:
Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Abel Salazar Biomedical Sciences Institute – University of Porto, Porto, Portugal
M Santos
Affiliation:
Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Abel Salazar Biomedical Sciences Institute – University of Porto, Porto, Portugal
B Leitao
Affiliation:
Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Abel Salazar Biomedical Sciences Institute – University of Porto, Porto, Portugal
A Silva
Affiliation:
Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Abel Salazar Biomedical Sciences Institute – University of Porto, Porto, Portugal
M Coutinho
Affiliation:
Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Abel Salazar Biomedical Sciences Institute – University of Porto, Porto, Portugal
*
Author for correspondence: Dr Andre Machado, Department of Otolaryngology, Centro Hospitalar Universitário do Porto, Largo Abel Salazar, Portugal E-mail: sousamachado.andre@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

This study aimed to understand, in a long-term follow-up study, whether the placement of grommets had been necessary after cleft palate surgical correction.

Method

A case–control, retrospective study was carried out on consecutive paediatric patients who underwent surgical repair of a cleft palate.

Results

The study population included 138 patients, divided into 2 groups: group 1 – patients in whom grommets were placed at the time of cleft palate surgery, and group 2 – patients in whom grommets were not placed at the time of cleft palate surgery. During the follow up, in groups 1 and 2, 65.2 per cent and 67.8 per cent, respectively, did not need subsequent grommet placement after cleft palate surgery.

Conclusion

Of patients, 56.5 per cent did not need ventilation tubes at any point during follow up. The placement of grommets is not innocuous; therefore, its use at the time of cleft palate surgical repair should be reconsidered.

Keywords

PalatePediatricsTympanic SurgeryChildrenOtitis
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 5 , May 2023 , pp. 501 - 505
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr A Machado takes responsibility for the integrity of the content of the paper

References

Lilja, J. Cleft lip and palate surgery. Scand J Surg 2003;92:269–73CrossRefGoogle ScholarPubMed
Tolarová, MM, Cervenka, J. Classification and birth prevalence of orofacial clefts. Am J Med Genet 1998;75:126–373.0.CO;2-R>CrossRefGoogle ScholarPubMed
Skolnik, E. Otologic evaluation in cleft palate patients. Laryngoscope 1958;68:1908–49CrossRefGoogle ScholarPubMed
Bruce, I, Harman, N, Williamson, P, Tierney, S, Callery, P, Mohiuddin, S et al. The management of Otitis Media with Effusion in children with cleft palate (mOMEnt): a feasibility study and economic evaluation. Health Technol Assess 2015;19:1–374CrossRefGoogle Scholar
Berryhill, W. Otologic concerns for cleft lip and palate patient. Oral Maxillofac Surg Clin North Am 2016;28:177–9CrossRefGoogle ScholarPubMed
Heidsieck, D, Smarius, B, Oomen, K, Breugem, C. The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems. Clin Oral Investig 2016;20:1389–401CrossRefGoogle ScholarPubMed
Gani, B, Kinshuck, A, Sharma, R. A review of hearing loss in cleft palate patients. Int J Otolaryngol 2012;2012:548698CrossRefGoogle ScholarPubMed
Doyle, W, Cantekin, E, Bluestone, C. Eustachian tube function in cleft palate children. Ann Otol Rhinol Laryngol Suppl 1980;89(3 Pt 2):34–40CrossRefGoogle ScholarPubMed
Grant, H, Quiney, R, Mercer, D, Lodge, S. Cleft palate and glue ear. Arch Dis Child 1988;63:176–9CrossRefGoogle ScholarPubMed
Paradise, J, Bluestone, C, Felder, H. The universality of otitis media in 50 infants with cleft palate. Pediatrics 1969;44:35–42CrossRefGoogle ScholarPubMed
Schönweiler, R, Schönweiler, B, Schmelzeisen, R, Ptok, M. Language and speech performance in 417 children with cleft formations [in German]. Fortschr Kieferorthop 1995;56:1–6CrossRefGoogle ScholarPubMed
Moore, I, Moore, G, Yonkers, A. Otitis media in the cleft palate patient. Ear Nose Throat J 1986;65:291–5Google ScholarPubMed
Gordon, A, Jean-Louis, F, Morton, R. Late ear sequelae in cleft palate patients. Int J Pediatr Otorhinolaryngol 1988;15:149–56CrossRefGoogle ScholarPubMed
Merrick, G, Kunjur, J, Markus, A. Incidence of secretory otitis media following functional repair of cleft palate. Br J Oral Maxillofac Surg 2001;226:39Google Scholar
Yaman, H, Yilmaz, S, Alkan, N, Subasi, B, Guclu, E, Ozturk, O. Shepard grommet tympanostomy tube complications in children with chronic otitis media with effusion. Eur Arch Otorhinolaryngol 2010;267:1221–4CrossRefGoogle ScholarPubMed
Kay, D, Nelson, M, Rosenfeld, R. Meta-analysis of tympanostomy tube sequelae. Otolaryngol Head Neck Surg 2001;124:374–80CrossRefGoogle ScholarPubMed
Weigel, M, Parker, M, Goldsmith, M, Postma, D, Pillsbury, H. A prospective randomized study of four commonly used tympanostomy tubes. Laryngoscope 1989;99:252–6CrossRefGoogle ScholarPubMed
Rosenfeld, R, Pynnonen, M, Tunkel, D, Schwartz, S. AAO-HNS Clinical Practice Guideline on Tympanostomy Tubes. Otolaryngol Head Neck Surg 2013;149:26Google Scholar
Kuo, C, Lien, C, Chu, C, Shiao, A. Otitis media with effusion in children with cleft lip and palate: a narrative review. Int J Pediatr Otorhinolaryngol 2013;77:1403–9CrossRefGoogle ScholarPubMed
Schönweiler, R, Lisson, J, Schönweiler, B, Eckardt, A, Ptok, M, Tränkmann, J et al. A retrospective study of hearing, speech and language function in children with clefts following palatoplasty and veloplasty procedures at 18–24 months of age. Int J Pediatr Otorhinolaryngol 1999;50:205–17CrossRefGoogle ScholarPubMed
Bess, F, Klee, T, Culbertson, J. Identification, assessment, and management of children with unilateral sensorineural hearing loss. Ear Hear 1986;7:43–51CrossRefGoogle ScholarPubMed
Takasaki, K, Sando, I, Balaban, C, Ishijima, K. Postnatal development of eustachian tube cartilage. A study of normal and cleft palate cases. Int J Pediatr Otorhinolaryngol 2000;52:31–6CrossRefGoogle ScholarPubMed
Bluestone, C. Studies in otitis media: Children's Hospital of Pittsburgh–University of Pittsburgh Progress Report – 2004. Laryngoscope 2004;114(Pt 3 Suppl 105):1–26CrossRefGoogle ScholarPubMed
Sharma, R, Nanda, V. Problems of middle ear and hearing in cleft children. Indian J Plast Surg 2009;42(suppl):S144–8CrossRefGoogle ScholarPubMed
Reyes, M, LeBlanc, E, Bassila, M. Hearing loss and otitis media in velo-cardio-facial syndrome. Int J Pediatr Otorhinolaryngol 1999;47:227–33CrossRefGoogle ScholarPubMed
Gereau, S, Steven, D, Bassila, M, Sher, A, Sidoti, E Jr, Morgan, M et al. Endoscopic observations of Eustachian tube abnormalities in children with palatal clefts. In: Lim, J, Bluestone, C, Klein, J, Nelson, J, eds. Recent Advances in Otitis Media. Toronto: BC Decker, 1988;60–3Google Scholar
Rajion, Z, Al-Khatib, A, Netherway, D, Townsend, G, Anderson, P, McLean, N et al. The nasopharynx in infants with cleft lip and palate. Int J Pediatr Otorhinolaryngol 2012;76:227–34CrossRefGoogle ScholarPubMed
Shprintzen, R, Croft, C. Abnormalities of the eustachian tube orifice in individuals with cleft palate. Int J Pediatr Otorhinolaryngol 1981;3:15–23CrossRefGoogle ScholarPubMed
Kemaloğlu, Y, Kobayashi, T, Nakajima, T. Analysis of the craniofacial skeleton in cleft children with otitis media with effusion. Int J Pediatr Otorhinolaryngol 1999;47:57–69CrossRefGoogle ScholarPubMed
Bluestone, C, Klein, J. Pediatric otolaryngology. In: Bluestone, C, Stool, S, Alper, C, eds. Pediatric Otolaryngology, 4th edn. Philadelphia: WB Saunders, 2003;474–685Google Scholar
Alper, C, Losee, J, Seroky, J, Mandel, E, Richert, B, Doyle, W. Resolution of otitis media with effusion in children with cleft palate followed through five years of age. Cleft Palate Craniofac J 2016;53:607–13CrossRefGoogle ScholarPubMed