Hearing thresholds and ventilation tube treatment in children with unilateral cleft lip and palate. (June 2017)

• Record Type: Journal Article
• Authors: Tengroth, Birgitta; Hederstierna, Christina; Neovius, Erik; Flynn, Traci
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 97(2017:Jun.)
• Page Start: 102
• Page End: 108
• Publication Date: 2017-06
• Subjects: Cleft lip and palate -- Hearing impairment -- Higher frequencies -- Otitis media with effusion -- Ventilation tube; CP ± L Cleft palate with/without cleft lip -- ET Eustachian Tube -- OME Otitis media with effusion -- PTA4 Four frequency pure tone average (500-1000-2000-4000 Hz) -- PTAHF Pure tone average high frequencies (6000–8000 Hz) -- dB HL decibel hearing level -- UCLP Unilateral cleft lip and palate -- VT Ventilation tube; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2017.03.031
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Objective: Children with cleft lip and palate have a high prevalence of otitis media with effusion (OME) which is often associated with a fluctuating, conductive hearing loss in the low and mid-frequencies and a risk for permanent hearing loss in the higher frequencies. Although common, there is no consensus on the treatment of OME with ventilation tubes. The aim of this study is to document if the risk for permanent hearing loss and acquired cholesteatoma increases due to treatment with ventilation tubes (VT treatments) during childhood in a group of children with cleft lip and palate. Methods: A retrospective medical chart review of 33 children (25 boys and 8 girls) born with unilateral cleft lip and palate (UCLP) was completed. Audiological data (results of hearing sensitivity tests, the total number of hearing tests, and number of VT treatments) were extracted from medical records from when the children were 4–7 and >7–10 years of age. Results: The hearing thresholds in the speech frequencies improved with age (p < 0, 05) but a minority of the children continued to present with elevated hearing thresholds in the higher frequencies at >7–10 years of age. There were no significant correlations between number of VT treatments and hearing thresholds at >7–10 years. Four of the 33 children presented with complications: two children exhibited perforations of the ear drum (6.1%) and two children developed unilateral cholesteatoma (6.1%). Conclusion: In the current study, the hearing sensitivity of children with cleft lip and palate improved with age. However, this improvement was not seen in the higher frequencies. Twelve percent of the children experienced complications following VT treatments. Due to these complications, it is recommended that all children with cleft palate should have routine follow-ups by an ENT doctor and audiologist. As part of the routine follow-up care, hearing assessments should be performed before and after VT treatments.