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Impact of pharyngofixation in cleft palate repair surgery on the development of chronic adhesive otitis media

Published online by Cambridge University Press:  22 March 2017

L Otruba ,
P Schalek  and
Z Hornáčková
L Otruba*
Affiliation:
Department of Otorhinolaryngology, 3rd Faculty of Medicine, Charles University and Královské Vinohrady University Teaching Hospital, Prague, Czech Republic
P Schalek
Affiliation:
Department of Otorhinolaryngology, 3rd Faculty of Medicine, Charles University and Královské Vinohrady University Teaching Hospital, Prague, Czech Republic
Z Hornáčková
Affiliation:
Department of Otorhinolaryngology, 3rd Faculty of Medicine, Charles University and Královské Vinohrady University Teaching Hospital, Prague, Czech Republic
*
Address for correspondence: Dr L Otruba, Department of Otorhinolaryngology, 3rd Medical Faculty Charles University and UTH Královské Vinohrady, Srobarova 50, 10034 Prague, Czech Republic E-mail: [email protected]
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Abstract

Background:

A significant percentage of children with cleft palate suffer from otitis media with effusion and its consequences, such as deafness, chronic adhesive otitis and cholesteatoma. This study aimed to determine whether these effects can be minimised by selecting pharyngofixation as the surgical technique for cleft palate correction.

Methods:

A retrospective study was performed of 155 patients (308 ears) who underwent surgery from age 5 months to 8 years and were followed up for 36–84 months.

Results:

In all, 125 ears (41 per cent) had epitympanic retraction, 45 ears (14 per cent) had sinus tympani retraction and 5 patients (3 per cent) had cholesteatoma. Use of the pharyngofixation technique did not significantly correlate with (1) the severity of otological findings or (2) the incidence of retraction pockets in the epitympanum and sinus tympani (p = 0.53).

Conclusion:

Pharyngofixation did not significantly alter the severity of long-term otological findings.

Keywords

CholesteatomaCleft PalateEustachian TubeMiddle Ear VentilationOtitis Media with Effusion
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 7 , July 2017 , pp. 645 - 649
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Kuo, CL, Lien, CF, Chia, HC, Shiao, AC. Otitis media with effusion in children with cleft lip and palate: A narrative review. Int J Pediatr Otorhinolaryngol 2013;77:1403–9Google Scholar
2 Rajion, ZA, Al-Khatib, AR, Netherway, DJ, Townsend, GC, Anderson, PJ, McLean, NR et al. The nasopharynx in infants with cleft lip and palate. Int J Pediatr Otorhinolaryngol 2012;76:227–34CrossRefGoogle ScholarPubMed
3 Sheahan, P, Blayney, AW, Sheahan, JN, Earley, MJ. Sequelae of otitis media with effusion among children with cleft lip and/or cleft palate. Clin Otolaryngol 2002;27:494–500 Google Scholar
4 Sheer, FJ, Swarts, JD, Ghadiali, SN. Three-dimensional finite element analysis of Eustachian tube function under normal and pathological conditions. Med Eng Phys 2011;34:605–16Google Scholar
5 Alper, M, Losee, JE, Mandel, EM, Seroky, JT, Swarts, JD, Doyle, WJ. Pre- and post-palatoplasty Eustachian tube function in infants with cleft palate. Int J Pediatr Otorhinolaryngol 2012;76:388–91Google Scholar
6 Harris, L, Cushing, SL, Hubbard, B, Fisher, D, Papsin, BC, James, AL. Impact of cleft palate type on the incidence of acquired cholesteatoma. Int J Pediatr Otorhinolaryngol 2013;77:695–8Google Scholar
7 Spilsbury, K, Miller, I, Semmens, JB, Lannigan, FJ. Factors associated with developing cholesteatoma: a study of 45,980 children with middle ear disease. Laryngoscope 2010;120:625–30Google Scholar
8 Vincenti, V, Marra, F, Bertoldi, B, Tonni, D, Saccardi, MS, Bacciu, S et al. Acquired middle ear cholesteatoma in children with cleft palate: experience from 18 surgical cases. Int J Pediatr Otorhinolaryngol 2014;78:918–22Google Scholar
9 Carroll, DJ, Padgitt, NR, Liu, M, Lander, TA, Tibesar, RJ, Sidman, JD. The effect of cleft palate repair technique on hearing outcomes in children. Int J Pediatr Otorhinolaryngol 2013;77:1518–22Google Scholar
10 Reiter, R, Haase, S, Brosch, S. Repaired cleft palate and ventilation tubes and their associations with cholesteatoma in children and adults. Cleft Palate Craniofac J 2009;46:598–602 Google Scholar
11 Smith, LK, Gubbels, SP, MacArthur, CJ, Milczuk, HA. The effect of the palatoplasty method on the frequency of ear tube placement. Arch Otolaryngol Head Neck Surg 2008;134:1085–9Google Scholar
12 Spauwen, PH, Ritsma, RJ, Huffstadt, BJ, Schutte, HK, Brown, IF. The inferiorly based pharyngoplasty: effects on chronic otitis media with effusion. Cleft Palate Craniofac J 1998;25:26–32 Google Scholar
13 Tiwari, R, Sharma, RK, Panda, NK, Munjal, S, Makkar, S. Tensor tenopexy: a clinical study to assess its efectiveness in improving Eustachian tube function and preventing hearing loss in patients with cleft palate. J Plast Reconstr Aesthet Surg 2013;66:e239–45 Google Scholar
14 Klockars, T, Rautio, J. Early placement of ventilation tubes in cleft lip and palate patients: does palatal closure affect tube occlusion and short-term outcome? Int J Pediatr Otorhinolaryngol 2012;76:1481–4CrossRefGoogle ScholarPubMed
15 Szabo, C, Langevin, K, Schoem, S, Mabry, K. Treatment of persistent middle ear effusion in cleft palate patients. Int J Pediatr Otorhinolaryngol 2010;74:874–7Google Scholar
16 Bluestone, CD. Anatomy and physiology of the eustachian tube. In: Cummings, CW, Fredrickson, JM, Harker, LE, eds. Otolaryngology Head and Neck Surgery, 3rd edn. St. Louis: Mosby, 1998;3003–22Google Scholar
17 Phua, YS, Salkeld, LJ, de Chalain, TMB. Middle ear disease in children with cleft palate: protocols for management. Int J Pediatr Otorhinolaryngol 2009;73:307–13CrossRefGoogle ScholarPubMed
18 Guneren, E, Ozsoy, Z, Ulay, M, Eryilmaz, E, Ozkul, H, Geary, PM. A comparison of the effects of Veau-Wardill-Kilner palatoplasty and Furlow double-opposing Z-plasty operations on eustachian tube function. Cleft Palate Craniofac J 2000;37:266–702.3.CO;2>CrossRefGoogle ScholarPubMed