Eustachian Tube Dysfunction in Children With Unilateral Cleft Lip and Palate: Differences Between Ipsilateral and Contralateral Ears

Objective: To evaluate Eustachian tube dysfunction in the ipsilateral and contralateral ears, in children with unilateral cleft lip and palate (UCLP). Design: Retrospective chart review. Setting: Tertiary care children’s hospital. Patients: Seventy-four consecutive patients with UCLP born between 2005 and 2011 and treated at UPMC Children’s Hospital of Pittsburgh Cleft-Craniofacial Center were included. Main Outcome Measures: Conductive hearing loss, tympanogram type, number of middle ear effusions, tympanostomy tubes, and complications. Hypothesis was formulated prior to data collection. Results: Conductive hearing loss was nearly twice as common in the ipsilateral ear (43.2%) compared with contralateral (23.0%; P = .001, McNemar test). There were no significant differences in the frequency of each type of tympanogram between the contralateral and ipsilateral ears. The proportions of ipsilateral (90.5%) and contralateral (91.9%) ears with effusion were not significantly different. The total number of tubes received was not significantly different between the 2 ears (median of 2 bilaterally). When combined, complications (retractions, perforations, and cholesteatomas) were significantly more common in the ipsilateral ear (29.7%) compared with the contralateral ear (18.9%; P = .039, McNemar test). Conclusion: In children with UCLP, there were significantly more instances of conductive hearing loss and complications on the cleft side compared to the noncleft side. This suggests that Eustachian tube dysfunction may indeed be more severe on the cleft side. Considering this information, clinicians may need to be especially observant of the ipsilateral ear.

[1]  P. Ravi,et al.  Abnormalities of the muscles of the soft palate and their impact on auditory function in patients operated on for cleft palate: a case-control study. , 2019, The British journal of oral & maxillofacial surgery.

[2]  M. Tarabichi,et al.  An overview of endoscopic ear surgery in 2018 , 2019, Laryngoscope investigative otolaryngology.

[3]  C. Senders,et al.  Children with Cleft Palate: Predictors of Otologic Issues in the First 10 Years , 2019, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[4]  C. Ibiapina,et al.  Cleft lip and palate associated hearing loss in Brazilian children. , 2018, International journal of pediatric otorhinolaryngology.

[5]  M. Bush,et al.  Disparities in access to pediatric hearing health care , 2017, Current opinion in otolaryngology & head and neck surgery.

[6]  K. Oomen,et al.  The role of the tensor veli palatini muscle in the development of cleft palate-associated middle ear problems , 2016, Clinical Oral Investigations.

[7]  A. Lohmander,et al.  A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate , 2013, The Laryngoscope.

[8]  M. Earley,et al.  Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. , 2003, International journal of pediatric otorhinolaryngology.

[9]  M. Earley,et al.  Sequelae of otitis media with effusion among children with cleft lip and/or cleft palate. , 2002, Clinical otolaryngology and allied sciences.

[10]  R. Rišavi,et al.  Tympanometric findings in cleft palate patients: influence of age and cleft type , 2001, The Journal of Laryngology & Otology.

[11]  D. Kuehn,et al.  An Anatomic Study of the Tensor Veli Palatini and Dilatator Tubae Muscles in Relation to Eustachian Tube and Velar Function , 1998 .

[12]  I. Smith,et al.  A conservative approach to the management of otitis media with effusion in cleft palate children , 1992, The Journal of Laryngology & Otology.

[13]  H. Takahashi,et al.  Abnormalities of Lateral Cartilaginous Lamina and Lumen of Eustachian Tube in Cases of Cleft Palate , 1991, The Annals of otology, rhinology, and laryngology.