First symptoms of secretory otitis media in newborns operated for cleft defect in a ten-year group
Authors:
M. Jurovčík 1; J. Borský 1; P. Dytrych 1
; Michal Černý 3
; J. Velemínská 4; L. Jaklová 4; K. Kotaška 2
; L. Hanousková 2; J. Skřivan 1
Authors place of work:
Klinika ušní, nosní a krční 2. LF UK a FN v Motole, Praha
1; Ústav lékařské chemie a klinické biochemie 2. LF UK a FN v Motole, Praha
2; Novorozenecké oddělení FN v Motole, Praha
3; Katedra antropologie a genetiky člověka, Přírodovědecká fakulta UK, Praha
4
Published in the journal:
Otorinolaryngol Foniatr, 69, 2020, No. 2, pp. 55-61.
Category:
Original Article
Summary
Introduction: Almost all patients with cleft palate suffer from Eustachian tube insufficiency.The result is usually the development of otitis media with effusion. Its first manifestation can be observed in newborns. The aim of this work is to detect the first symptoms of the disease during the first phase of the surgical solution - the primary suture of the lip, which we perform in neo-neonatal age. Another goal is to evaluate the value of objective audiological methods in relation to the diagnosis of middle ear fluid.
Material and methods: In a ten-year period, a group of 314 patients with cleft defects were evaluated, who had primary lip suture in the neonatal period. Prior to the procedure, OAE, standard 226 Hz and high frequency 1000 Hz tympanometry were examined. However, it was not possible to complete all examinations in all patients. In case of suspicion of presence of middle ear secretion, otomicroscopy with diagnostic paracentesis was performer.
Results: Over ten years, lip surgery was performed in 314 newborns, 241 to 7 days of age. Most patients (57) were operated on the third postpartum day. 178 patients had cleft lip and palate, 136 patients had cleft lip. A total of 394 ears with a 1000 Hz probe and a 408 standard 226 Hz probe were examined. Middle ear fluid was detected in 74% of patients with cleft palate (unilaterally or bilaterally). The middel ear fluid appeared regularly on the non-cleft side, where the tubular torus was normally morphologically configured. In 96% the result of 1000 Hz tympanometric examination (B curve) coincided with the finding of middle ear fluid.
Conclusion: Middle ear secretion was detected in newborns, but only in those who had cleft palate. In all patients with isolated cleft lip, the middle ear was airy. The presence of secretion does not depend on the cleft side. High-frequency tympanometry is a highly conclusive method for determining the presence of middle ear fluid in newborns.
Keywords:
newborns – otitis media with effusion – cleht palate
Zdroje
1. Bluestone, C. D.: Eustachian tube obstruction in the infant with cleft palate. Ann Otol Rhinol Laryngol, 80, 1971, Suppl 2, s. 1–30.
2. Borský, J., Tvrdek, M., Kozák, J., et al.: Our first experience with primary lip repair in newborns with cleft lip and palate. Acta Chir Plast, 49, 2007, 4, s. 83–87.
3. Borský, J., Velemínská, J., Jurovčík, M., et al.: Successful early neonatal repair of cleft lip within first 8 days of life. Int J Pediatr Otorhinolaryngol, 76, 2012, 11, s. 1616–1626.
4. Boone, R. T., Bower, C. M., Martin, P. F.: Failed newborn hearing screens as presentation for otitis media with effusion in the newborn population. Int J Pediatr Otorhinolaryngol, 69, 2005, 3 s. 393–397.
5. Broen, P. A., Moller, K. T., Carlstrom, J., et al.: Comparison of the hearing histories of children with and without cleft palate. Cleft Palate-Craniofacial J, 33,1996, 2, s. 127–133.
6. Caganova, V., Borsky, J., Smahel, Z., et al.: Facial growth and development in unilateral cleft lip and palate: Comparison between secondary alveolar bone grafting and primary periosteoplasty. Cleft Palate-Craniofacial J, 51, 2014, 1, s. 15–22.
7. Doyle, W. J., Cantekin, E. I., Bluestone, C. D.: Eustachian tube function in cleft palate children. Ann Otol Rhinol Laryngol, 89, 1980, 3, s. 34–40.
8. Galinier, P., Salazard, B., Deberail, A., et al.: Neonatal repair of cleft lip: a decision-making protocol. J Pediatr Surg, 43, 2008, 4, s. 662–667.
9. Goodacre, T. E. E., Hentges, F., Moss, T. L. H., et al.: Does repairing a cleft lip neonatally have any effect on the longer-term attractiveness of the repair? Cleft Palate-Craniofacial J, 41, 2004, 6, s. 603–608.
10. Graham, J. M., Scadding, G.K., Bull, P. D.: Pediatric ENT. Berlin, Heidelberg, Springer Verlag, 2007.
11. Hammoudeh, J. A., Imahiyerobo, T. A., Liang, F., et al.: Early Cleft Lip Repair Revisited: A Safe and Effective Approach Utilizing a Multidisciplinary Protocol. Plast Reconstr Surg - Glob Open, 5, 2017, 6, s. 1340.
12. Huang, C. S., Wang, W. I., Jein-Wein, L. E., et al.: Effects of cheiloplasty on maxillary dental arch development in infants with unilateral complete cleft lip and palate. Cleft Palate-Craniofacial J, 39, 2002, s. 513–516.
13. Chen, Y. W., Philip Chen, K. T., Chang, P. H., et al.: Is otitis media with effusion almost always accompanying cleft palate in children?: The experience of 319 Asian patients. Laryngoscope, 122, 2012, 1, s. 220–224.
14. Jurovčík, M., Sýba, J., Myška, P., et al.: Multi-Frequency audiometry and its importance to pediatric audiology. Otorinolaryngol Foniatr, 58, 2009, 3, s. 169.
15. Klockars, T., Rautio, J.: Early placement of ventilation tubes in cleft lip and palate patients: Does palatal closure affect tube occlusion and short-term outcome? Int J Pediatr Otorhinolaryngol, 76, 2012, 10, s. 1481–1484.
16. Kuo, C. L., Lien, C. F., Chu, C. H., et al.: Otitis media with effusion in children with cleft lip and palate: A narrative review. Int J Pediatr Otorhinolaryngol, 77, 2013, 9, s. 1403–1409.
17. de Lyra-Silva, K. A., Sanches, S. G. G., Neves-Lobo, I. F.,et al.: Middle ear muscle reflex measurement in neonates: Comparison between 1000Hz and 226Hz probe tones. Int J Pe-diatr Otorhinolaryngol, 79, 2015, 9, s. 1510–1515.
18. Le Pendeven, R., Martinot-Duquennoy, V., Pellerin, P.: Long-term morphologic results of a 32 successive patients series presenting unilateral complete cleft lip and palate with surgery at early age. Ann Chir Plast Esthet, 54, 2009, 1, s. 7–15.
19. Margolis, R. H., Bass-Ringdahl, S., Hanks, W. D., et al.: Tympanometry in newborn infants--1 kHz norms. J Am Acad Audiol, 14, 2003, 7, s. 383–392.
20. Mazaheri, M., Athanasiou, A. E., Long, R. E., et al.: Evaluation of maxillary dental arch form in unilateral clefts of lip, alveolus, and palate from one month to four years. Cleft Palate-Craniofacial J, 30, 1993, 1, s. 90–93.
21. McHeik, J. N., Sfalli, P., Bondonny, J. M., et al.: Early repair for infants with cleft lip and nose. Int J Pediatr Otorhinolaryngol, 70, 2006, 10, s. 1785–1790.
22. Nakajima, T., Yoshimura, Y.: Early repair of unilateral cleft lip employing a small triangular flap method and primary nasal correction. Br J Plast Surg, 46, 1993, 7, s. 616–618.
23. Odoi, H., Proud, G. O., Toledo, P. S.: Effects of pterygoid hamulotomy upon eustachian tube function. Laryngoscope, 81, 1971, 8, s. 1242–1244.
24. Peterka, M., Peterková, R., Tvrdek, M., et al.: Significant differences in the incidence of orofacial clefts in fifty-two Czech districts between 1983 and 1997. Acta Chir Plast, 42, 2000, 4, s. 124–129.
25. Petráčková, I., Zach, J., Borský, J., et al.: Early and late operation of cleft lip and intelligence quotient and psychosocial development in 3-7years. Early Hum Dev, 91, 2015, 2, s. 149–152.
26. Robinson, P. J., Lodge, S., Jones, B. M., et al.: The effect of palate repair on otitis media with effusion. Plast Reconstr Surg, 89, 1992, 4, s. 640–645.
27. Sadler-Kimes, D., Siegel, M. I., Todhunter, J. S.: Age-related morphologic differences in the components of the eustachian tube/middle ear system. Ann Otol Rhinol Laryngol, 98, 1989, 11, s. 854–858.
28. Shaw, R. J., Richardson, D., McMahon, S.: Conservative management of otitis media in cleft palate. J Cranio-Maxillofacial Surg, 31, 2003, 5, s. 316–320.
29. Sheahan, P., Blayney, A. W.: Cleft palate and otitis media with effusion: A review. Rev Laryngol Otol Rhinol, 124, 2003, 3, s. 171–177.
30. Sheahan, P., Miller, I., Sheahan, J. N., et al.: Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. Int J Pediatr Otorhinolaryngol, 67, 2003, 7, s. 785–793.
31. Schönweiler, R., Lisson, J. A., Schönweiler, B., et al.: A retrospective study of hearing, speech and language function in children with clefts following palatoplasty and veloplasty procedures at 18-24 months of age. Int J Pediatr Otorhinolaryngol, 50, 1999, 3, s. 205–217.
32. Šmahel, Z., Velemínská, J., Trefný, P., et al.: Three-dimensional morphology of the palate in patients with bilateral complete cleft lip and palate at the stage of permanent dentition. Cleft Palate-Craniofacial J, 41, 2009, 4, s. 399–408.
33. Tierney, S., O’Brien, K., Harman, N. L., et al.: Risks and benefits of ventilation tubes and hearing aids from the perspective of parents of children with cleft palate. Int J Pediatr Otorhinolaryngol, 77, 2013, 10, s. 1742–1748.
34. Urbanova, W., Kotova, M., Vankova, Z.: The incidence of cleft lip and palate in the Czech Republic in 1994-2008. Bratislava Med J, 114, 2013, 8, s. 474–479.
35. Valtonen, H., Dietz, A., Qvarnberg, Y.: Long-term clinical, audiologic, and radiologic outcomes in palate cleft children treated with early tympanostomy for otitis media with effusion: A controll-ed prospective study. Laryngoscope, 115, 2005, 8, s. 1512–1516.
36. Van Boven, M. J., Pendeville, P. E., Veyckemans, F., et al.: Neonatal cleft lip repair: The anesthesiologist’s point of view. Cleft Palate-Craniofacial J, 30, 1993, 2, s. 574–578.
37. Weber, B. C., Whitlock, S. M., He, K., et al.: An evidence based protocol for managing neonatal middle ear effusions in babies who fail newborn hearing screening. Am J Otolaryngol, 39, 2018, 5, s. 609–612.
38. Weinfeld, A. B., Hollier, L. H., Spira, M., et al.: International trends in the treatment of cleft lip and palate. Clin Plast Surg, 32, 2005, 1, s. 19–23.
Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)Článok vyšiel v časopise
Otorhinolaryngology and Phoniatrics
2020 Číslo 2
Najčítanejšie v tomto čísle
- Measurement of oropharyngeal pH in the diagnosis of laryngopharyngeal reflux
- COVID-19 from the point of view of an otorhinolaryngologist, an overview of the situation two months after the first cases of infection in our countries; evidence based
- Cervical hematoma caused by parathyroid adenoma
- Cone-beam Computed Tomography (CBCT) of temporal bone after cochlear implantation – first experiences