Middle Ear Disease in Children with Congenital Velopharyngeal Insufficiency

2004 ◽  
Vol 41 (4) ◽  
pp. 364-367 ◽  
Author(s):  
Patrick Sheahan ◽  
Ian Miller ◽  
Michael J. Earley ◽  
Jerome N. Sheahan ◽  
Alexander W. Blayney
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Middle Ear ◽  
Medical Records ◽  
Velopharyngeal Insufficiency ◽  
Type I ◽  
Significant Difference ◽  
History Of ◽  
Ear Infections ◽  
Middle Ear Disease

Objective To examine the incidence and natural history of middle ear disease in children with congenital velopharyngeal insufficiency (VPI) without cleft palate. Setting and Subjects Children with congenital VPI attending the combined cleft clinic at a tertiary cleft center. The diagnosis of congenital VPI in all cases was confirmed be the observation of hypernasality, nasal air escape, or both by a speech and language therapist and the demonstration of incompetence of the velopharyngeal sphincter by means of nasoendoscopy or videofluoroscopy. Children with overt cleft palate or postsurgical VPI were excluded. Design The children's medical records were reviewed, and a questionnaire regarding history of ear problems was sent to all parents. Children were divided into those with Pruzansky type I VPI (showing bifid uvula, midline diastasis of soft palate, or submucous cleft of the hard palate) and Pruzansky type II VPI (no visible stigmata). Main Outcome Measures Incidence of reported ear problems, ear infections, hearing loss, and surgical intervention for middle ear disease in the whole group and in each of the subgroups. Results Seventy-one parents returned completed questionnaires. The overall incidence of middle ear disease was 63%, with 28% reported to have below-normal hearing. There was no significant difference between children with Pruzansky types I and II VPI with respect to incidence of otopathology or hearing loss. Conclusions Irrespective of the presence of any visible palatal abnormalities, children with congenital VPI showed a substantial incidence of otopathology and should thus be closely monitored.

scholarly journals Adenoidectomy for middle ear disease in cleft palate children: a systematic review

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Mario Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
Alberto Maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

Abstract Purpose Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group are scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at collecting the available evidence on this subject, to frame possible further areas of research and interventions. Methods A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. Results Among 321 unique citations, 3 studies published between 1964 and 1972 (2 case series and a retrospective cohort study) were deemed eligible, with 136 treated patients. The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution. Conclusion Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data are, therefore, available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

scholarly journals Speech Outcomes after Tonsillectomy in Patients with Known Velopharyngeal Insufficiency

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
L. M. Paulson ◽  
C. J. MacArthur ◽  
K. B. Beaulieu ◽  
J. H. Brockman ◽  
H. A. Milczuk
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Palate ◽  
Speech Intelligibility ◽  
Velopharyngeal Insufficiency ◽  
Speech Evaluation ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Before And After ◽  
History Of

Introduction. Controversy exists over whether tonsillectomy will affect speech in patients with known velopharyngeal insufficiency (VPI), particularly in those with cleft palate.Methods. All patients seen at the OHSU Doernbecher Children's Hospital VPI clinic between 1997 and 2010 with VPI who underwent tonsillectomy were reviewed. Speech parameters were assessed before and after tonsillectomy. Wilcoxon rank-sum testing was used to evaluate for significance.Results. A total of 46 patients with VPI underwent tonsillectomy during this period. Twenty-three had pre- and postoperative speech evaluation sufficient for analysis. The majority (87%) had a history of cleft palate. Indications for tonsillectomy included obstructive sleep apnea in 11 (48%) and staged tonsillectomy prior to pharyngoplasty in 10 (43%). There was no significant difference between pre- and postoperative speech intelligibility or velopharyngeal competency in this population.Conclusion. In this study, tonsillectomy in patients with VPI did not significantly alter speech intelligibility or velopharyngeal competence.

Effect of Certain Head and Neck Tumors and Their Treatment on the Ventilatory Function of the Eustachian Tube and Hearing Loss

1983 ◽  
Vol 92 (6_suppl) ◽  
pp. 24-25
Author(s):  
E. N. Myers ◽  
Q. C. Beery ◽  
C. D. Bluestone ◽  
M. B. Möller ◽  
B. A. Sigler ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Animal Models ◽  
Cleft Palate ◽  
Head And Neck ◽  
Middle Ear ◽  
Clinical Condition ◽  
Ventilatory Function ◽  
Neck Tumors ◽  
Pathological Conditions ◽  
Middle Ear Disease

The management of patients with middle ear disease should be based on an understanding of the pathogenesis of the disease and its course. In this group of investigations, patients with pathological conditions such as cleft palate, which affects ET function, are studied. Animal models are then developed to simulate the clinical condition, thus providing a method of isolating the variables.

Comparison of the Hearing Histories of Children with and without Cleft Palate

1996 ◽  
Vol 33 (2) ◽  
pp. 127-133 ◽  
Author(s):  
Patricia A. Broen ◽  
Karlind T. Moller ◽  
Jane Carlstrom ◽  
Shirley S. Doyle ◽  
Monica Devers ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Medical Records ◽  
Otitis Media With Effusion ◽  
Hearing Screening ◽  
Tube Placement ◽  
Ventilation Tube ◽  
Ventilation Tubes

Aggressive otologic management has been recommended for children with cleft palate because of the almost universal occurrence of otitis media with effusion (OME) in these children and the association of OME with hearing loss and possible language, cognitive, and academic delays. In this study, 28 children with cleft palate and 29 noncleft children were seen at 3-month intervals from 9 to 30 months to compare otologic treatment and management. Hearing and middle ear function were tested at each session; information on ventilation tube placement was obtained from medical records. Ventilation tubes were placed earlier and more often in children with cleft palate, but children with cleft palates failed the hearing screening more often. The correlation between age at first tube placement and frequency of hearing screening failures was significant for the children with cleft palate, indicating that the later tubes were first placed, the poorer the child's hearing.

scholarly journals Did we get lost in the Seventies? Adenoidectomy for middle ear disease in cleft palate children: a systematic review.

2021 ◽  
Author(s):  
Cecilia Rosso ◽  
Antonio Bulfamante ◽  
Carlotta Pipolo ◽  
Emanuela Fuccillo ◽  
alberto maccari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cleft Palate ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Case Series ◽  
Velopharyngeal Insufficiency ◽  
Middle Ear Disease ◽  
Conductive Hearing

OBJECTIVES: Cleft palate children have a higher incidence of otitis media with effusion, more frequent recurrent acute otitis media episodes, and worse conductive hearing losses than non-cleft children. Nevertheless, data on adenoidectomy for middle ear disease in this patient group is scarce, since many feared worsening of velopharyngeal insufficiency after the procedure. This review aims at filling this knowledge gap by collecting the available evidence on this subject, to frame possible further areas of research and interventions. DESIGN: A PRISMA-compliant systematic review was performed. Multiple databases were searched with criteria designed to include all studies focusing on the role of adenoidectomy in treating middle ear disease in cleft palate children. After duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for clinical indications and outcomes. RESULTS: Among 321 unique citations, 3 studies were deemed eligible (2 case series and a retrospective cohort study). The outcomes were positive in all three articles in terms of conductive hearing loss improvement, recurrent otitis media episodes reduction, and effusive otitis media resolution (this last result being not statistically significant). CONCLUSION: Despite promising results, research on adenoidectomy in treating middle ear disease in the cleft population has stopped in the mid-Seventies. No data is therefore available on the role of modern conservative adenoidectomy techniques (endoscopic and/or partial) in this context. Prospective studies are required to define the role of adenoidectomy in cleft children, most interestingly in specific subgroups such as patients requiring re-tympanostomy, given their known risk of otologic sequelae.

Comparison of Risk of Conductive Hearing Loss Among Three Ethnic Groups of Arctic Audiology Patients

1999 ◽  
Vol 42 (6) ◽  
pp. 1311-1322 ◽  
Author(s):  
Jan Allison Moore
Keyword(s):  
Risk Factors ◽  
Hearing Loss ◽  
Ethnic Group ◽  
Ethnic Groups ◽  
Hearing Impairment ◽  
Middle Ear ◽  
Conductive Hearing Loss ◽  
History Of ◽  
Middle Ear Disease ◽  
Conductive Hearing

The purpose of the study was to investigate the relative contributions of age, gender, ethnic background, and a history of middle ear disease on the amount of conductive hearing impairment among native and non-native audiology patients in the Canadian North. A second goal of the study was to determine risk factors for conductive hearing loss in the patients studied. Three ethnic groups were represented among the 3,094 patients: Inuit, American Indian, and non-native. Loglinear and logit statistical models were applied, and these data were best explained by a 3-way interaction of history of middle ear disease, ethnic group, and hearing loss, and the 2-way interaction of age and hearing loss. The Inuit appear to be at higher risk for conductive hearing impairment than the other ethnic groups. Conductive hearing loss also appears to increase as age increases through the teenage years for all the patients regardless of ethnic group membership. Preschoolers were at the lowest risk for conductive hearing loss. The trend for the amount of hearing impairment to increase throughout childhood suggests that children living in the Arctic may manifest a unique and more serious form of the disease not often observed in audiology patients who are Caucasian in southern Canada or the United States or that they may be exposed to additional risk factors.

Reading performance in children with otitis media

2005 ◽  
Vol 132 (3) ◽  
pp. 495-499 ◽  
Author(s):  
Avishay Golz ◽  
Aviram Netzer ◽  
S. Thomas Westerman ◽  
Liane M. Westerman ◽  
David A. Gilbert ◽  
...  
Keyword(s):  
Middle Ear ◽  
Medical Records ◽  
Reading Performance ◽  
Study Group ◽  
Healthy Children ◽  
Recurrent Infections ◽  
Reading Tests ◽  
Ear Diseases ◽  
History Of ◽  
Middle Ear Disease

OBJECTIVE: To examine whether middle ear diseases and the associated hearing loss in early childhood affect reading performance later at school. STUDY DESIGN AND SETTING: One hundred and sixty children, 6.5 to 8 years of age, were enrolled in this study: 80 children with a history of recurrent infections and/or prolonged periods of effusions of the middle ear before the age of 5 years, and 80 healthy children without any history of middle ear disease. Data were collected from the medical records of the children. Every child underwent a complete otological and audiological evaluation, followed by special reading tests. RESULTS: The study group performed more poorly, in all reading tests, as compared to the controls ( P < 0.001). CONCLUSION: Children with recurrent or prolonged middle ear diseases during the first five years of life tend to be at greater risk for delayed reading than aged-matched controls with no previous middle ear diseases.

scholarly journals Mastoiditis in adults: Diagnostic and therapeutic aspects

2004 ◽  
Vol 51 (1) ◽  
pp. 109-112
Author(s):  
S. Krejovic-Trivic ◽  
Dragoslava Djeric ◽  
Aleksandar Trivic
Keyword(s):  
Hearing Loss ◽  
Early Diagnosis ◽  
Middle Ear ◽  
Medical Records ◽  
Pathological Process ◽  
The Other ◽  
Adequate Treatment ◽  
Long Period ◽  
Intravenous Antibiotics ◽  
History Of

The purpose of the present study is to report our experience in the diagnosis and treatment of mastoiditis in adults. Five patients with an active chronic otitis and mastoiditis were presented. All of them had a history of chronic ear discharge for long period of time and have been diagnosed and treated sufficiently. All relevant data were analyzed from the medical records. The most common symptoms of the disease were otalgia, otorrhea and hearing loss, but the physical signs of mastoiditis (swelling, erithema and tenderness of the retroauricular region) were presented in all cases. Localization and enlargement of the pathological process within the middle ear spaces was determined by CT. All patients were treated surgically and with intravenous antibiotics. In one patient the other treatment was applied due to a specific (TBC) process in the ear. Early diagnosis and adequate treatment (surgeiy combined with an effective antibiotics therapy) is most important to prevent a serious complications of mastoiditis (extracranial and/or intracranial).

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