Gas Exchange Function of the Middle Ear Mucosa in Patients with Cleft Palate

Abstract

Using nitrous oxide, the gas exchange function of the middle ear mucosa was examined in 14 patient with cleft palates, twenty-five ears without otitis media, who had undergone various surgeries under general anesthesia, as well as 18 normal ears with neither cleft palate nor otitis media (controls) were examined. The middle ear pressure increased after the inhalation of nitrous oxide in all of the ears with the cleft palates and controls. However, the middle ear pressure increase was significantly smaller in the ears with the cleft palates than in the controls (Mann-Whitney U-test, P<0.05). This gas exchange function was also examined using the same method in 84 ears with otitis media with effusion (OME), including 7 patients (14 ears) with cleft palates. In 9 of these 14 ears with the cleft palates, the gas exchange function was found to be impaired, and it was also impaired in 33 of the 70 ears without cleft palates. In the ears with OME, the gas exachange function tended to be more impaired in the ears with the cleft palates than in those ears without the cleft palates. In those ears with OME, the area of the mastoid examined by X-ray (Schuller's view) was significantly larger in these ears without the cleft palate than in those with the cleft palate (Mann-Whitney U-test, P<0.05).
It is suggested that the gas exchange function of the middle ear mucosa was poorer in these ears with a cleft palate than in normal ears. In the ears with a cleft palate, both the eustachian tube function and the gas exchange function of the middle ear mucosa seemed to be disrupted. This might cause susceptibility to middle ear diseases and refractory middle ear diseases.