Abnormalities and weakness of the tensor veli palatini and levator muscles in cleft palates can lead to Eustachian tube dysfunction and, in the long term, to otitis media with cholesteatoma.
From January 2014 to December 2018, 16 ears were treated with tympanoplasty for cholesteatom associated with cleft palate and were followed up for more than 1 year. The main findings of this study are the pathological classifications of cholesteatoma, operative procedures, hearing improvement, residual cholesteatoma rates, and recurrent cholesteatoma rates.
In terms of pathological classifications of cholesteatoma, 66.7% of fresh cases (8 out of 12 ears) were pars tensa cholesteatoma. Canal wall up tympanoplasty (including transcanal tympanoplasty) was performed in 91.7% of cases (11 out of 12 ears). Hearing improvement was achieved in 68.8% of cases (11 of 16 ears) according to JOS criteria.
Residual cholesteatoma rates were 6.3% (1 out of 16 ears), and recurrent cholesteatoma rates were 0% (0 out of 12 fresh cases); postoperative ventilation tube placement was required in 33.3% of cases (4 out of 12 ears).
Thus, use of thin-sliced cartilage to preserve the posterior wall of the external auditory canal is considered a good operative procedure in cases of cholesteatoma associated with cleft palate, which may decrease Eustachian tube function.
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