Evolution of Acquired Middle Ear Cholesteatoma in Patients With Ectrodactyly, Ectodermal Dysplasia, Cleft Lip/Palate (EEC) Syndrome

Lourençone, Luiz Fernando Manzoni; Koga, Fernanda Dias Toshiaki; Oliveira, Eduardo Boaventura; Jorge, José Carlos Moura; Brito, Rubens de

doi:10.1097/mao.0000000000001921

Cited by 3 publications

(5 citation statements)

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“…Patients with both cleft lip and cleft palate repair made up 61.4% of the group with cleft palate repair. Most studies analyzed outcomes after myringoplasty or tympanoplasty, 29,43–46 but some studies included tympanomastoidectomy 47–49 . Four studies excluded patients with cholesteatoma 43,44,46,50 , 4 studies included only patients with cholesteatoma 47–49,51 , and 3 studies included a range of patients with cholesteatoma (5.0%‐36.8%) 28,29,45 .…”

Section: Resultsmentioning

confidence: 99%

“…Different descriptions of procedure success were extracted, with the most common being no revision surgery and intact tympanic membrane. The 4 studies of patients with cholesteatoma considered recurrent cholesteatoma as their procedure success 47–49,51 . Mean follow‐up ranged from 25.0 to 160.8 months for patients with cleft palate repair and 31.3 to 75.0 months for controls.…”

Section: Resultsmentioning

confidence: 99%

“…Only 4 studies analyzed patients with cleft palate repair and cholesteatoma, [47][48][49]51 and just 1 study reported on controls. 51 For patients with a prior cleft palate repair, the proportion of cholesteatoma recurrence was 30.5% (95% CI, 8.7%-58.4%; Figure 10).…”

Section: Cholesteatoma Recurrencementioning

confidence: 99%

“…The 4 studies of patients with cholesteatoma considered recurrent cholesteatoma as their procedure success. [47][48][49]51 Mean follow-up ranged from 25.0 to 160.8 months for patients with cleft palate repair and 31.3 to 75.0 months for controls.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Most studies analyzed outcomes after myringoplasty or tympanoplasty, 29,[43][44][45][46] but some studies included tympanomastoidectomy. [47][48][49] Four studies excluded patients with cholesteatoma 43,44,46,50 , 4 studies included only patients with cholesteatoma [47][48][49]51 , and 3 studies included a range of patients with cholesteatoma (5.0%-36.8%). 28,29,45 Different descriptions of procedure success were extracted, with the most common being no revision surgery and intact tympanic membrane.…”

Section: Patient Characteristicsmentioning

confidence: 99%

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Outcomes of Tympanoplasty After Cleft Palate Repair: A Systematic Review and Meta‐analysis

Poupore

Smaily

Carroll

et al. 2022

Otolaryngol.--head neck surg.

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Objective To analyze graft success rates and hearing outcomes in patients with a history of cleft palate (CP) repair undergoing tympanoplasty. Data Sources PubMed, Scopus, and CINAHL. Review Methods Per PRISMA guidelines, the databases were searched from date of inception through December 14, 2021. Studies of patients with previous CP repair who underwent tympanoplasty were included. Meta-analysis of proportions, continuous measures, odds ratios (ORs), and meta-regression were used to analyze graft success and hearing outcomes after tympanoplasty. Results A total of 323 patients with CP repair and 1169 controls were included. The proportion of graft success was 86.7% (95% CI, 76.1%-94.5%) in patients with CP repair and 88.8% (95% CI, 76.9-96.8) in controls. There was no difference in odds of graft success between patients with CP repair and controls (OR, 1.0 [95% CI, 0.5-1.8]; P = .870). Age was not a significant moderator of graft success in patients with CP repair ( r = 0.1 [95% CI, −0.2 to 0.3]; P = .689) or controls ( r = −0.0 [95% CI, −0.1 to 0.1]; P = .952). Comparing mean differences between pre- and postoperative air-bone gap was not statistically significant in patients with CP repair and controls (0.2 dB [95% CI, −3.1 to 3.4]; P = .930). Odds of functional success (postoperative air-bone gap <20 dB) were not different between the groups (OR, 0.8 [95% CI, 0.5-1.4]; P = .450). Conclusion This meta-analysis does not endorse anatomic or functional differences between patients with CP repair and controls after tympanoplasty. However, there is a paucity of evidence for younger children. Further studies are warranted to elucidate specific risk factors for tympanoplasty outcomes in young patients with previous CP repair.

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