Natural History of Tympanic Membrane Retraction in Children with Cleft Palate

The natural history of tympanic membrane retraction is unpredictable. To obtain prognostic information for guiding surveillance and treatment, a cohort of children with retraction from cleft palate were prospectively followed for over 5 years. This was a prospective observational study at a tertiary...

Full description

Saved in:
Bibliographic Details
Published in:The journal of international advanced otology 2018-08, Vol.14 (2), p.250-254
Main Authors: Parkes, William, Vilchez-Madrigal, Luis, Cushing, Sharon, Papsin, Blake, James, Adrian
Format: Article
Language:English
Subjects:
Causes of
Children
Cleft palate
Complications and side effects
Diseases
Ear diseases
Eardrum
Ears & hearing
Endoscopy
Hearing loss
Original
Otolaryngology
Otology
Pediatrics
Risk factors
Surgery
Thermometers
Tympanic membrane
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The natural history of tympanic membrane retraction is unpredictable. To obtain prognostic information for guiding surveillance and treatment, a cohort of children with retraction from cleft palate were prospectively followed for over 5 years. This was a prospective observational study at a tertiary academic institution. Children with pars tensa retraction were selected from a cohort of 143 children with cleft palate. Thirty-seven ears were assessed with otoendoscopic image capture and audiometry at a median age of 9 years and reassessed at a median follow-up interval of 6.4 years. The severity of tympanic membrane retraction in the serial images of each ear was compared by four pediatric otolaryngologists blinded to the dates of the images. Initially, 19/37 retractions (51%) demonstrated contact with the incus and/or promontory. Follow-up images were rated as stable (n=16) or better (n=12) for 28/37 retractions (76%). Of the nine retractions that became more extensive, two developed cholesteatoma (5% of the total). No ossicular erosion developed in ears without cholesteatoma. Conductive hearing loss (4-tone average air-bone gap >25 decibels hearing level) was initially present in five ears, worsened in one, and normalized without intervention in others. No ears with initial normal hearing developed hearing loss. Most tympanic membrane retractions remained stable or improved over time in this cohort of children who were at a risk of persistent eustachian tube dysfunction. Clinically significant progression occurred infrequently, justifying the conservative approach taken to manage these retractions. Such data are necessary to weigh the potential benefit of preventive intervention over observation.
ISSN:1308-7649
2148-3817
DOI:10.5152/iao.2018.5609