[Otological findings in adults with isolated cleft palate or cleft lip, jaw, and palate].
BACKGROUND
Children with cleft palate often develop middle ear ventilation disorders due to chronic Eustachian tube dysfunction. This may lead to hearing loss. The insertion of ventilation tubes is a widely accepted measure to avoid sequelae of middle ear ventilation disorders and hearing loss. On the other hand, long-term therapy with ventilation tubes may inflict iatrogenic complications. The objective of the study was the evaluation of otoscopic and audiometric long-term findings in adult cleft patients who had been treated with ventilation tubes since childhood when chronic otitis media with effusion had been observed.


METHODS
Ninety-two cleft palate patients had been followed up otoscopically and audiometrically for years. The average age was 19.3 years (minimum: 14, maximum: 39 years) at the time the last status was taken.


RESULTS
Otoscopy revealed a perforation of the tympanic membrane in 3.8% of the 184 ears. 12% of the patients developed cholesteatoma, however three quarters of these occurred after age 11. 86.4% of the 92 patients had normal hearing in pure tone audiometry.


CONCLUSIONS
Compared with adult cleft patients who did not receive ventilation tubes, our patients had a similar low incidence of eardrum perforations but a higher incidence of cholesteatomas while hearing loss occurred less often. Whether the higher incidence of cholesteatomas is caused iatrogenically or due to a longer follow-up period remains unclear. Whether the use of long-lasting ventilation tubes affects the incidence of cholesteatomas must be proved in further studies.
Gudziol
V
V
HNO-Klinik der Universität Mainz, Mainz.gudziol@hno.klinik.uni-mainz.de
Mann
W J
WJ
D000293:Adolescent; D000328:Adult; D001301:Audiometry, Pure-Tone; D018424:Cholesteatoma, Middle Ear / Q000175:diagnosis / Q000209:etiology*; D002908:Chronic Disease; D002972:Cleft Palate / Q000150:complications* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008876:Middle Ear Ventilation; D010034:Otitis Media with Effusion / Q000150:complications* / Q000601:surgery; D038781:Otoscopy; D011183:Postoperative Complications / Q000209:etiology*; D018058:Tympanic Membrane Perforation / Q000175:diagnosis / Q000209:etiology*