Effects of rapid maxillary expansion on hearing loss and otitis media in cleft palate children

Abstract

Purpose Otitis media with effusion (OME), recurrent acute otitis media and conductive hearing loss (CHL) are significantly prevalent in children with cleft palate (CP) and cleft lip and palate (CLP). Rapid Maxillary Expansion (RME) appears to have a positive effect also on middle ear disorders in these patients. The study aims to offer a prospective evaluation of RME effects in a group of patients with CP/CLP in terms of OME, CHL. Methods A prospective observational study was conducted. Thirty-four CP, CLP and submucosa cleft patients who received orthodontic indication to RME treatment for OME or conductive hearing loss in a tertiary institutional Care Unit of San Paolo Hospital, Milan (IT), were included. Twenty-two patients matched for age and with analogous inclusion criteria except for indication to RME treatment were enrolled in the control group. Clinical otolaryngological evaluation, pure tone audiometry and tympanogram were performed at the beginning of treatment (T0), at the end of the expansion (T1) and at 6-month follow-up (T2). Main outcome measures: Air-bone gaps and tympanogram results at each time interval. Results In the main group, RME allowed a statistically significant improvement of air-bone gaps (according to frequency, p < 0.001-0.089 T0 vs. T1 and < 0.001-0.044 T0 vs. T2, Friedman's test) and tympanometry results (p = 0.002 T0 vs. T1 and p < 0.001 T0 vs. T2, Friedman's test). Improvements were stable during follow-up and were significantly better in the main group than in the control group. Conclusion CHL and middle ear effusion improved significantly overtime during RME and after 6 months of follow-up.

Upper Airway Expansion in Disabled Children

“…Also, ETA proved beneficial in causing significant improvement in patients having combined cleft lip and palate [54]. These children's conductive hearing loss and middle ear effusion improved significantly during RME and after six months of follow-up [55]. Also, a study showed that the correction of the palatal anatomy through RME had a positive and statistically significant effect on improving hearing and middle ear function in patients without cleft and with bilateral cleft lip and palate, with normal hearing levels and with mild conductive hearing loss.…”