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cleft palate, middle ear

Mark Felton, Jong Wook Lee, Darius D Balumuka, Jugpal S Arneja, Neil K Chadha
Objective Studies have shown that the majority of cleft lip and palate (CLP) children have middle ear fluid present at the time of lip repair (3-4 months). Despite hearing loss, the majority of children do not undergo ventilation tube treatment if required until the time of palate repair (9-12 months). We aimed to examine the effectiveness and potential complications of early ventilation tube placement prior to palatoplasty in infants with cleft lip and palate. Data Sources Medline (1946-2015), Embase (1980-2015), and EBM Reviews (Cochrane Central Register of Controlled)...
November 1, 2017: Otolaryngology—Head and Neck Surgery
Letícia Helena de Sousa Marques, Daniela Vieira Martins, Gabriel Liria Juares, Fábio Tadeu Moura Lorenzetti, Rafael da Costa Monsanto
OBJECTIVE: To describe and discuss otologic manifestations of Larsen syndrome, based on a case report and a systematic review of the literature. MATERIALS AND METHODS: We performed a PubMED database search, and we selected studies reporting otolaryngologic manifestations secondary to Larsen syndrome. The selected articles were read in full, and three researchers independently extracted data from the studies. In parallel, we report the case of a 14-year-old patient who had hearing loss secondary to Larsen syndrome...
October 2017: International Journal of Pediatric Otorhinolaryngology
Udi Cinamon, Dov Albukrek, Yahav Oron, Sharon Ovnat Tamir, Abraham Goldfarb, David Dvir, Tal Marom
BACKGROUND: The Eustachian tube (ET) has a major role in the middle ear (ME) pressure homeostasis. ET dysfunction is the accepted paradigm for pressure-related ME disorders. We studied the ME status in patients with severely diminished ET opening abilities, and anticipated to find ME disorders in most of them. PATIENTS AND METHODS: ME status was evaluated in unconscious adults, who were hospitalized in a rehabilitation center with severe brain damage, requiring tracheotomy and gastrostomy...
September 2017: Otology & Neurotology
Tina L Samuels, Justin C Yan, Pawjai Khampang, Peter W Dettmar, Alexander MacKinnon, Wenzhou Hong, Nikki Johnston, Blake C Papsin, Robert H Chun, Michael E McCormick, Joseph E Kerschner
Importance: Persistent, viscous middle ear effusion in pediatric otitis media (OM) contributes to increased likelihood of anesthesia and surgery, conductive hearing loss, and subsequent developmental delays. Biomarkers of effusion viscosity and hearing loss have not yet been identified despite the potential that such markers hold for targeted therapy and screening. Objective: To investigate the association of gel-forming mucins and aquaporin 5 (AQP5) gene expression with inflammation, effusion viscosity, and hearing loss in pediatric OM with effusion (OME)...
August 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
Y Yang, M Chen, J S Hao, W Liu, J Zhang
Objective: To summarize the characteristics of children diagnosed as cleft palate associated with middle ear cholesteatoma. Methods: There were five middle ear cholesteatoma cases who had previously received cleft palate repairment surgery. All of the patients were followed up for 17 to 47 months. Median follow-up time was 31 months. Results: There were three males and two females with three to eleven years old , and the average of age was seven years and ten months. The time of cleft palate repairment surgery was from six months to four years, and the average age was one year and nine months...
May 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Makoto Ito, Haruo Takahashi, Yukiko Iino, Hiromi Kojima, Sho Hashimoto, Yosuke Kamide, Fumiyo Kudo, Hitome Kobayashi, Haruo Kuroki, Atsuko Nakano, Hiroshi Hidaka, Goro Takahashi, Haruo Yoshida, Takeo Nakayama
OBJECTIVE: To (1) indicate the definition, the disease state, methods of diagnosis, and testing for otitis media with effusion (OME) in childhood (<12 years); and (2) recommend methods of treatment in accordance with the evidence-based consensus reached by the Subcommittee of Clinical Practice Guideline for Diagnosis and Management of OME in Children. METHODS: We produced Clinical Questions (CQs) concerning the treatment of OME and searched the literature published until April 2014 according to each theme including CQ, the definition, the disease state, the method of diagnosis, and examination...
May 1, 2017: Auris, Nasus, Larynx
Amber D Shaffer, Matthew D Ford, Sukgi S Choi, Noel Jabbour
Objective Describe the impact of hearing loss, tympanostomy tube placement before palatoplasty, and number of tubes received on speech outcomes in children with cleft palate. Study Design Case series with chart review. Setting Tertiary care children's hospital. Subjects and Methods Records from 737 children born between April 2005 and April 2015 who underwent palatoplasty at a tertiary children's hospital were reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, sensorineural or mixed hearing loss, no tubes, first tubes after palatoplasty, or first clinic after 12 months of age...
September 2017: Otolaryngology—Head and Neck Surgery
I F P M Kappen, J B S Schreinemakers, K P Q Oomen, D Bittermann, M Kon, C C Breugem, A B Mink van der Molen
OBJECTIVE: To evaluate long-term hearing and middle ear status in patients treated for a unilateral complete cleft lip and palate (UCLP) by two-stage palatoplasty. METHODS: Forty-nine UCLP patients aged 17 years and older were included in this retrospective study. Patients were invited for a multidisciplinary long-term follow-up of their treatment at a tertiary center for craniofacial surgery in the Netherlands. ENT assessment included tympanometry and pure-tone audiometry...
March 2017: International Journal of Pediatric Otorhinolaryngology
Andre Wineland, Maithilee D Menezes, Joshua S Shimony, Marwan S Shinawi, Timothy E Hullar, Keiko Hirose
Importance: CHARGE syndrome refers to a syndrome involving coloboma, heart defects, atresia choanae, retardation of growth and development, genitourinary disorders, and ear anomalies. However, Verloes revised the characteristics of CHARGE syndrome in 2005 to define this syndrome more broadly. Deficiency of the semicircular canals is now a major criterion for CHARGE syndrome. Objective: To characterize patients with CHARGE syndrome at our center using Verloes' criteria and to reevaluate the nomenclature for this condition...
February 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
Cuneyt M Alper, Joseph E Losee, James T Seroky, Ellen M Mandel, Beverly C Richert, William J Doyle
OBJECTIVE: To describe the temporal pattern of otitis media with effusion (OME) resolution for a cohort of nonsyndromic cleft palate children enrolled before palatoplasty and followed through 5 years of age. DESIGN: This is a prospective, longitudinal study of the time course for OME resolution in infants and children with palatal clefts. SETTING: Cleft Palate Craniofacial Center of a tertiary care pediatric hospital. PARTICIPANTS: This study included 52 children with cleft palate (29 boys, 45 white, Veau 1 through 4) who had a Furlow-type palatoplasty between 10 and 24 months of age performed by one of six surgeons...
September 2016: Cleft Palate-craniofacial Journal
Bernard Ars, Joris Dirckx
The fibrocartilaginous eustachian tube is part of a system of contiguous organs including the nose, palate, rhinopharynx, and middle ear cleft. The middle ear cleft consists of the tympanic cavity, which includes the bony eustachian tube (protympanum) and the mastoid gas cells system. The tympanic cavity and mastoid gas cells are interconnected and allow gaseous exchange and pressure regulation. The fibrocartilaginous eustachian tube is a complex organ consisting of a dynamic conduit with its mucosa, cartilage, surrounding soft tissue, peritubal muscles (ie, tensor and levator veli palatine, salpingopharyngeus and tensor tympani), and superior bony support (the sphenoid sulcus)...
October 2016: Otolaryngologic Clinics of North America
Elissa Kim, Melissa D Kanack, Milan D Dang-Vu, Daniela Carvalho, Marilyn C Jones, Amanda A Gosman
OBJECTIVE:   The purpose of this study was to assess the effect of ventilation tube (VT) placement on long-term hearing outcomes in children with cleft palate. STUDY DESIGN:   Case series with chart review. SETTING:   Genetic and dysmorphology database at Rady Children's Hospital-San Diego (RCHSD). PATIENTS:   Children with cleft palate diagnosis who underwent surgery at RCHSD between 1995 and 2002. MAIN OUTCOME MEASURE:   The primary outcome studied was hearing acuity at 10 years of age...
November 2017: Cleft Palate-craniofacial Journal
Pawina Jiramongkolchai, Manvinder S Kumar, Sivakumar Chinnadurai, Christopher T Wootten, Steven L Goudy
OBJECTIVE: The purpose of this study was to determine the prevalence and characterize the types of hearing loss in pediatric patients with 22q11.2 deletion syndrome (22q11DS). METHODS: Fifty-eight patients were identified via retrospective chart review performed of patients with 22q11DS between 1996 and 2014. Patient demographics, pertinent family history, associated comorbidities, and degree and type of hearing loss were gathered for each patient. A literature review of the National Library of Medicine's database with a focus on hearing loss and 22q11DS was performed...
August 2016: International Journal of Pediatric Otorhinolaryngology
David S P Heidsieck, Bram J A Smarius, Karin P Q Oomen, Corstiaan C Breugem
OBJECTIVE: Otitis media with effusion is common in infants with an unrepaired cleft palate. Although its prevalence is reduced after cleft surgery, many children continue to suffer from middle ear problems during childhood. While the tensor veli palatini muscle is thought to be involved in middle ear ventilation, evidence about its exact anatomy, function, and role in cleft palate surgery is limited. This study aimed to perform a thorough review of the literature on (1) the role of the tensor veli palatini muscle in the Eustachian tube opening and middle ear ventilation, (2) anatomical anomalies in cleft palate infants related to middle ear disease, and (3) their implications for surgical techniques used in cleft palate repair...
September 2016: Clinical Oral Investigations
Chii-Yuan Huang, Chuan-Song Wu, Chao-Hsiun Tang, Mao-Che Wang, Ting-Yu Kuo, Tzong-Yang Tu
CONCLUSION: Palatoplasty can significantly decrease their middle ear re-intubation rate with a relatively lower hazard ratio compared to children who underwent VTI only. OBJECTIVES: In children with cleft palate, questions remain about the overall effect of ventilation tube insertion (VTI) and palatoplasty for their OME. A large-scale study might offer more evidence for the roles of palatal surgery. SUBJECTS AND METHODS: This was a retrospective birth cohort study based upon a national database...
August 2016: Acta Oto-laryngologica
Anuj Jain, Pranali Nimonkar, Nitin Bhola, Rajiv Borle, Anendd Jadhav, Shishir Sharma, Shrenik Oswal
The primary goal of palatoplasty is to achieve a tension-free palatal closure ensuring no postoperative complications. Many surgeons fracture the pterygoid hamulus to minimize tension during palatoplasty. However, this maneuver gained criticism by some authors on the grounds that it may lead to Eustachian Tube dysfunction. Our study intended to figure out the relationship of hamulus fracture with the postoperative state of middle ear in cleft palate children. Fifty consecutive cleft palate patients with an age range of 10 months to 5 years were recruited...
2016: Scientifica
Sharan Naidoo, Kurt W Bütow
The tensor veli palatini muscle is involved in opening of the Eustachian tube during chewing and swallowing, allowing for equilibration of pressure between the middle ear and external environment. In patients with cleft palate, abnormal musculature in the region of the cleft results in Eustachian tube dysfunction. A palatoplasty with muscle repositioning is advocated to reduce the incidence of otitis media, which is a result of this. A special suture is described which can be incorporated into a palatoplasty procedure to further reduce the incidence of otitis media...
July 2015: Annals of Maxillofacial Surgery
Ville Lehtonen, Riitta H Lithovius, Timo J Autio, George K Sándor, Leena P Ylikontiola, Virpi Harila, Paula Pesonen, Sari Koskinen, Vuokko Anttonen
PURPOSE: Middle ear problems are common in cleft patients. This study aimed to determine the need for ventilation tubes (VTs) and complications such as tympanic perforation and cholesteatoma. MATERIAL AND METHODS: Data of 156 children with clefts managed in northern Finland spanning 15 years from 1997 to 2011 were collected from 6 hospitals. The following were recorded: birth date, gender, cleft type, surgery timing, surgery type, number of tube insertions, tube material, middle ear findings, and tube placement timing...
April 2016: Journal of Cranio-maxillo-facial Surgery
J Smallridge, A J Hall, R Chorbachi, V Parfect, M Persson, A J Ireland, A K Wills, A R Ness, J R Sandy
OBJECTIVES: To compare oral health and hearing outcomes from the Clinical Standards Advisory Group (CSAG, 1998) and the Cleft Care UK (CCUK, 2013) studies. SETTING AND SAMPLE POPULATION: Two UK-based cross-sectional studies of 5-year-olds born with non-syndromic unilateral cleft lip and palate undertaken 15 years apart. CSAG children were treated in a dispersed model of care with low-volume operators. CCUK children were treated in a centralized, high volume operator system...
November 2015: Orthodontics & Craniofacial Research
Sen Li, Hong Zhang, Yun Wei, Xilei Zhang, Yingru Wu, Jiang Qian, Liang Shen, Zhengjian Zhang
OBJECTIVE: To discuss the treatment characteristics of secretory otitis media (SOM) in cleft palate children. METHODS: A total of 319 patients (524 ears) with SOM and cleft palate (3-14 years old) who accepted treatment were divided into experiment group A, group B, and group C according to effusion characteristics in the middle ear and tympanic pressure. Group A included 112 patients with serous effusion (198 ears). Group B included 162 patients with mucinous effusion (248 ears)...
June 2015: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
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