Our Summary

This study looked at children who had surgery for cleft palate (a condition where a baby’s palate, or roof of the mouth, doesn’t form properly during pregnancy) at a hospital in Barcelona between 2000 and 2014. The researchers wanted to see if the severity of the cleft palate or the number of ventilation tubes a patient received was related to problems with the eardrum, hearing loss, or speech issues.

The researchers found that the severity of the cleft and the number of ventilation tubes used during surgery didn’t affect the patient’s hearing loss or eardrum problems. However, they found a link between a more severe cleft and a speech issue called hypernasality (when too much air escapes through the nose during speech). They also found that hypernasality was related to chronic inflammation of the middle ear, hearing loss, and the number of ventilation tubes used.

The study concludes that while using ventilation tubes can increase the risk of chronic inflammation in the middle ear, it’s still unclear whether this is due to the tubes themselves or if it’s part of the natural progression of middle ear inflammation in patients with cleft palate. The study also found that more aggressive treatment of chronic ear inflammation with ventilation tubes didn’t improve speech, hearing, or eardrum problems.

FAQs

  1. Does the severity of the cleft palate or the number of ventilation tubes used during surgery affect hearing loss or eardrum problems?
  2. What is the relationship between a severe cleft palate, hypernasality, and the use of ventilation tubes?
  3. Does aggressive treatment of chronic ear inflammation with ventilation tubes improve speech, hearing, or eardrum issues in patients with cleft palate?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft palate surgery is to closely follow post-operative care instructions to help prevent complications and promote healing. This may include keeping the surgical site clean, avoiding certain foods or activities that could put strain on the area, and attending follow-up appointments with the surgeon for monitoring and adjustments as needed. Additionally, it’s important for patients to communicate any concerns or changes in symptoms to their healthcare provider promptly.

Suitable For

Patients who are typically recommended cleft palate surgery are infants and children with a cleft palate deformity that affects their ability to eat, speak, and breathe properly. The severity of the cleft palate, the presence of chronic ear inflammation, hearing loss, and speech issues are all factors that may indicate the need for surgical intervention. It is important for patients with cleft palate to be evaluated by a multidisciplinary team of healthcare professionals, including plastic surgeons, otolaryngologists, speech therapists, and audiologists, to determine the best course of treatment.

Timeline

Before cleft palate surgery:

  1. Diagnosis of cleft palate during pregnancy or shortly after birth.
  2. Consultation with a team of medical professionals to discuss treatment options.
  3. Pre-operative appointments and evaluations to assess the severity of the cleft palate and determine the best course of action.
  4. Discussion with the surgical team about the procedure, risks, and recovery process.

After cleft palate surgery:

  1. Recovery period in the hospital, which may include pain management and monitoring for any complications.
  2. Follow-up appointments with the surgical team to assess healing and address any concerns.
  3. Speech therapy to help the patient learn to speak properly with the repaired palate.
  4. Monitoring for any long-term complications, such as chronic inflammation of the middle ear or hearing loss.
  5. Continued follow-up care to ensure the best possible outcome for the patient’s speech and overall health.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft palate surgery based on this study include:

  1. What is the severity of my cleft palate and how does it impact my potential for speech issues such as hypernasality?
  2. Will I need ventilation tubes during surgery and how does this impact my risk for chronic inflammation in the middle ear?
  3. What are the potential risks and benefits of using ventilation tubes for chronic ear inflammation in patients with cleft palate?
  4. How will my hearing be monitored after surgery and what are the potential long-term effects on my eardrum and hearing?
  5. How can I best manage any speech issues that may arise after cleft palate surgery, particularly hypernasality?

Reference

Authors: Garcia-Vaquero C, Mir C, Graterol D, Ortiz N, Rochera-Villach MI, LLeonart ME, Lorente J. Journal: BMC Pediatr. 2018 Nov 8;18(1):350. doi: 10.1186/s12887-018-1312-7. PMID: 30409226