Otoscopic and tympanometric findings in infants with cleft lip and palate

Feniman, Mariza Ribeiro; Souza, Adriana Guerta de; Jorge, José Carlos Moura; Lauris, José Roberto Pereira

doi:10.1016/s1808-8694(15)31096-x

Cited by 9 publications

(7 citation statements)

References 22 publications

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“…This is contradictory to prior research. Studies in which otolaryngologic maintenance care and PE tube placement reported that complete and bilateral clefts require additional PE tube placements secondary to persistent effusions and lesser hearing improvement over time, respectively (Ahn et al, 2012; Feniman et al, 2008; Handžic-Cuk et al, 1996). Finally, most studies have identified no gender predilection for later increased risk for otologic disease, with a minority reporting an increased risk in males (Ahn et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Younger children tend to have a higher prevalence of middle ear effusions and hearing loss than older children (Chen et al, 2012; Dhillon, 1988; Grant et al, 1988). Otologic disease is often seen as a gender-neutral issue, although some evidence suggests males require additional pressure equalization (PE) tubes (Feniman et al, 2008). Similarly, children with complete cleft palates rather than incomplete clefts require PE tubes more often following surgery and recover Eustachian tube function more slowly as they age (Handžic-Cuk et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Otologic Disease Following Palatoplasty In International Cleft Palate Cohort

Markey

Maine

Daniels

et al. 2017

The Cleft Palate Craniofacial Journal

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Otologic Disease Following Palatoplasty In International Cleft Palate Cohort

Markey

Maine

Daniels

et al. 2017

The Cleft Palate Craniofacial Journal

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“…For example, AC screenings were not robust in identifying conductive components because of the middle ear pathology, bone conduction (BC) testing was not explored as ambient noise levels could not be monitored without appropriate instrumentation, and tympanometry was not sensitive in identifying middle ear problems in individuals with CLP. Feniman et al (2008), reported that only 65% of infants showed middle ear problems through tympanometry, as compared with 84% through otomicroscopy. D'Mello and Kumar (2007) reported that tympanometry, with confirmation by the otolaryngologist, was successful in detecting the presence of middle ear effusion, cerumen, and chronic suppurative otitis media.…”

Section: Introductionmentioning

confidence: 99%

Tele-Audiological Surveillance of Middle Ear Status among Individuals with Cleft Lip and/or Palate in Rural South India

et al. 2020

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A community-based program for the comprehensive management of communication disorders among individuals with cleft lip and/or palate (CLP) was implemented in two rural districts in the state of Tamil Nadu, India. The program was successful in terms of early surgical repair, orthodontic management and speech correction; however, audiological surveillance was challenging due to poor follow-up rates.The aim of the study was to compare tele-audiological and in-person audiological surveillance to identify the most beneficial approach for the identification and treatment of middle ear disease (MED) in individuals with CLP in this rural community-based program.Quasi-experimental study.All beneficiaries older than 5 years actively seeking services in Cuddalore (n = 44) and Thiruvannamalai (n = 65) districts of Tamil Nadu, India, were included in the study. Individuals in Cuddalore district were assigned to the tele-audiological surveillance group, whereas individuals in Thiruvannamalai district were assigned to the in-person audiological surveillance group.In the tele-audiological surveillance group, video-otoscopy examinations were performed by trained community-based rehabilitation workers (CBRWs). Pure-tone audiometry and tympanometry were performed by an audiologist from the tertiary care hospital through remotely accessed equipment using broadband internet at the participants’ homes and monthly camps. Findings from those with suspected MED were forwarded to the otolaryngologist at the tertiary care hospital for remote diagnoses and treatment plans. Subsequently, CBRWs relayed the otolaryngologist’s recommendations to the individuals receiving services at the community. In the in-person audiological surveillance group, video-otoscopy, pure-tone audiometry, and tympanometry were performed by the audiologist following standard testing procedures at monthly camps. Individuals with suspected MED and impacted cerumen were referred for in-person diagnoses and treatment plans. Follow-up audiological surveillance was conducted in both districts after implementation of the otolaryngologist’s recommendations.The coverage, follow-up rate for intervention and cost-outcomes from the provider's perspective were analyzed and compared between two groups.Tele-audiological surveillance provided superior coverage (68%) compared with in-person audiological surveillance (38%). The tele-audiological surveillance group showed greater follow-up compliance (61%) than the in-person audiological surveillance group (19%) for treatment plans such as cerumen management and hearing aid fitting provided locally. Compared with in-person audiological surveillance, tele-audiological surveillance resulted in cost saving of USD 47 per individual.Tele-audiological surveillance was beneficial for the purpose of identifying and providing treatment in patients having CLP with MEDs in rural locations.

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“…Feniman et al had also concluded that it was difficult to get a proper tympanometry results by using single frequency probe (226 Hz) in infants below 5 months of age. 8 Multiple frequency probes have been advocated for very small infants. Therefore single frequency probe was highly unreliable in age below 6 months of age.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Eustachian tube function in patients of cleft palate and effects of palatoplasty on these findings

Kochar

Chauhan

Bajaj

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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Background: Isolated cleft palate and cleft palate and cleft lip patients have poor Eustachian tube function which results in hearing impairment that too in the speech formative years. Aim of study was to evaluate tympanometric findings in patient of cleft palate and effect of palatoplasty on both short term and long term postoperatively.Methods: The subjects consisted of patients attending the cleft lip and palate clinic. This was a combined clinic consisting of department of plastic surgery, department of ENT and department of dental surgery held every month at a tertiary care hospital in Delhi. Study consisted of three groups of patients namely preoperative group, postoperative group and pre-postoperative group.Results: No significant difference was observed in tympanometric abnormalities in cases of combined cleft lip and palate as compared to isolated cleft palate. After age of 5 months once changes of OME has set in there was no significant change in middle ear findings irrespective of palatal repair.Conclusions: There is a very high prevalence of otitis media with effusion in these patients. The changes do resolve spontaneously after age of seven, this perhaps is due to combined effect, growth, development and l maturity of Eustachian tube and palatal surgery rather than palatal surgery alone.

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Otoscopic and tympanometric findings in infants with cleft lip and palate

Cited by 9 publications

References 22 publications

Otologic Disease Following Palatoplasty In International Cleft Palate Cohort

Otologic Disease Following Palatoplasty In International Cleft Palate Cohort

Tele-Audiological Surveillance of Middle Ear Status among Individuals with Cleft Lip and/or Palate in Rural South India

Evaluation of Eustachian tube function in patients of cleft palate and effects of palatoplasty on these findings

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