Children with cleft palate who received tympanostomy tubes during primary palatoplasty showed measurable hearing gains on postoperative audiometry, according to a study in Ear, Nose & Throat Journal. In a cohort treated at Maastricht University Medical Centre, average hearing improved by 14 decibels, and nearly 9 in 10 pediatric patients demonstrated better air-conduction thresholds.
Middle ear disease was frequent in this group. Before surgery, 89% of patients had otitis media with effusion, conductive hearing loss was found in 32% and sensorineural loss in 5%. Hearing tests conducted within the first postoperative year—typically about 3 months after surgery—showed consistent improvement.
Tympanostomy tubes were inserted during the palate repair for patients with middle ear effusion or recurrent ear infections. Repeat tube placement was occasionally required, but lasting eardrum abnormalities were uncommon. Isolated cases included tympanic-membrane perforation, atelectasis, or myringosclerosis, mainly among those who underwent multiple insertions.
Researchers reviewed records from June 2012 to April 2024 of nonsyndromic patients who underwent single-stage cleft palate repair with concurrent tympanostomy tube insertion and follow-up audiometry within 6 months. Hearing loss was defined as a high Fletcher index greater than 30 decibels at 1, 2, and 4 kilohertz. Two surgeons performed repairs using either a two-flap palatoplasty or a Furlow double opposing Z-plasty technique. Statistical modeling accounted for repeated measures within patients.
“Tympanostomy tube placement improves hearing outcomes in children with cleft palate. When OME is present at the time of cleft surgery or there is a documented history of recurrent OME or acute otitis media, concurrent tube placement should be considered to alleviate conductive hearing loss,” wrote lead study author Nina Wijnants, MD, of Maastricht University Medical Centre, and colleagues.
The analysis was limited by the modest sample size, lack of a control group, and variable follow-up periods. Missing data on cleft type and prior infections further restricted interpretation, and the retrospective design precluded establishing causation.
The authors reported no conflicts of interest.
Source: Ear, Nose & Throat Journal