title: Retrospective analysis of tympanoplasty in children with cleft palate: a 22-year experience: I. Mesotympanic (non-cholesteatomatous) cases.
abstract: BACKGROUND
  Contradictory data have been published on the outcomes of ear surgeries in cleft patients.
  
  
  OBJECTIVE
  To investigate whether there are differences in the short and long term outcomes of tympanoplasty performed due to childhood chronic mesotympanic otitis media in patients without and with cleft palate.
  
  
  METHODS
  Tertiary care pediatric medical centre.
  
  
  METHODS
  The authors retrospectively analysed the first author's data on pediatric tympanoplasties of the past 22 years with the help of a computer programme developed by the third author. The outcomes of 159 'NoCleft' tympanoplasties (119 patients, 144 ears) were compared to the outcomes of 31 'Cleft' tympanoplasties (21 patients, 27 ears) with the average age of the patients being 10.8 and 10.7 years accordingly.
  
  
  RESULTS
  The preoperative ABG (28.76/28.94dB, p = 0.468), the best postoperative ABG (12.78/10.04dB, p = 0.096), the last postoperative ABG (15.59/13.19dB, p = 0.192), the final hearing gain (13.17/15.75dB, p = 0.253) and the postoperative ABG deterioration associated with time (2.81/3.15dB, p = 0.376) were statistically compared in the 'NoCleft'/'Cleft' groups. No significant difference was found between the outcomes of the two groups. The same parameters were examined separately after tympanoplasties performed with intact ossicular chain and after those requiring columella ossiculoplasty. The 'Cleft' group did not have worse outcomes in this respect, either. The average follow-up period of the patients was more than 3 years in both groups. The graft take rate was 100%, reperforation occurred in 3.5% of the cases in both groups. In their study, grommet insertion was more likely to be necessary in the 'Cleft' group.
  
  
  CONCLUSIONS
  The authors concluded that there was no significant difference between the expectable outcomes of pediatric tympanoplasties in patients with and without cleft palate regarding mesotympanic cases; therefore, the indications for tympanoplasty are the same in the two groups. They outline the importance of the therapeutic management of cleft patients in the frameworks of a "Cleft Palate Team" and the necessity for their lifelong otorhinolaryngological care due to their vulnerable Eustachian tube function. They are planning to publish the same comparative analysis of their patients with cholesteatoma in a following study.
authors.affiliation: Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary. Electronic address: kopcsanyi.gabor@pte.hu.
authors.forename: Gábor
authors.initials: G
authors.lastname: Kopcsányi
authors.affiliation: Department of Pediatrics, University of Pécs Medical School, Pécs, Hungary.
authors.forename: Olga
authors.initials: O
authors.lastname: Vincze
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Pécs Medical School, Pécs, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Pytel
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D018424:Cholesteatoma, Middle Ear; D002972:Cleft Palate / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010033:Otitis Media / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D013997:Time Factors; D016896:Treatment Outcome; D014433:Tympanoplasty / Q000009:adverse effects / Q000379:methods*; D055815:Young Adult
keywords: Cleft palate; Long-term follow-up; Mesotympanic cases; Pediatric tympanoplasty