OTITIS MEDIA WITH EFFUSION IN CLEFT PALATE

Abstract

　Children with cleft palate (CP) often develop the complication of intractable otitis media with effusion. The increased risk of this complication in children with CP is attributable to Eustachian tube dysfunction. We previously reported that children with CP had a smaller mastoid air cell area than those without CP, and showed that the mastoid air cell area increased as the age advanced, although there was no significant increase in the area in response to ventilation tube (VT) placement. Of the CP patients treated by VT placement, approximately 30% were very intractable cases requiring such surgical measures as VT re-placement or tympanoplasty even at 6 years of age or later.

　It is recommended undergo a neonatal hearing screening test. Eardrum status should be evaluated before palatoplasty. When referred for a neonatal hearing screening test, hearing tests should be performed. When otitis media with effusion has been found to persist for 3 months or more, when the eardrum findings are poor, when there is clear bilateral hearing loss, and when there is language delay, VT placement should be performed. If at that time, the pathological changes in the eardrum are not prominent, prescribing a hearing aid may be considered. When eardrum status is very poor, an imaging examination should be considered. It is necessary to give a consideration to minimizing the impact of radiation exposure. Long-term follow-up is necessary.