Our Summary

This study aimed to understand if there was a significant difference in the success rates of a specific type of ear surgery (tympanoplasty) and hearing outcomes between two groups of people: those who had previously undergone repairs for a cleft palate (a birth defect where the roof of the mouth contains an opening into the nose) and those who had not.

The researchers reviewed various studies on this subject that were available on databases like PubMed, Scopus, and CINAHL up until December 14, 2021. They included studies involving people who had a cleft palate repair and then underwent tympanoplasty.

After analyzing data from a total of 323 patients with cleft palate repair and 1169 controls (i.e., people who did not have a cleft palate repair), they found that the success rate of the graft (a part of the surgery where tissue is moved from one site to another) was almost the same between the two groups - 86.7% for the cleft palate repair group and 88.8% for the controls. The odds (chances) of graft success were also essentially the same for both groups. Age didn’t significantly affect graft success in either group.

They also compared the differences in a measure of hearing (called the air-bone gap) before and after the surgery and found no noticeable differences between the two groups. Similarly, the odds of achieving a positive hearing outcome (measured by a postoperative air-bone gap of less than 20 dB) were not different between the groups.

In conclusion, this study found no substantial differences in the success of the tympanoplasty procedure or hearing outcomes between those who had previously undergone cleft palate repair and those who had not. However, they noted a lack of information regarding younger children and suggested that more research is needed to understand specific risk factors for tympanoplasty outcomes in young patients who had cleft palate repair.

FAQs

  1. What was the success rate of graft in patients with a history of cleft palate repair who underwent tympanoplasty?
  2. Is there a difference in the odds of graft success between patients who have undergone a cleft palate repair and controls after tympanoplasty?
  3. Does age significantly affect graft success in patients with cleft palate repair or controls after tympanoplasty?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft palate surgery is to follow post-operative care instructions closely to ensure optimal healing and reduce the risk of complications. This may include keeping the surgical site clean, avoiding certain foods or activities that could disrupt the healing process, and attending follow-up appointments as scheduled. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients with a history of cleft palate repair who are experiencing tympanic membrane perforations, conductive hearing loss, or recurrent ear infections are typically recommended for cleft palate surgery. These patients may benefit from tympanoplasty to repair the eardrum and improve hearing outcomes. Younger children with cleft palate repair may also be candidates for tympanoplasty, although further research is needed to understand specific risk factors and outcomes in this population.

Timeline

Before cleft palate surgery:

  • Diagnosis of cleft palate is made either prenatally or shortly after birth
  • Patient undergoes pre-operative evaluations and consultations with a multidisciplinary team including surgeons, speech therapists, and otolaryngologists
  • Patient may receive pre-operative counseling and education on the surgery and post-operative care
  • Surgical date is scheduled and patient may need to undergo additional tests or procedures before the surgery

After cleft palate surgery:

  • Patient undergoes the surgical procedure to repair the cleft palate
  • Patient is monitored in the hospital for a period of time after the surgery
  • Patient may experience pain, swelling, and discomfort in the days following the surgery
  • Patient will have follow-up appointments with the surgical team to monitor healing and address any concerns
  • Patient may need speech therapy and other interventions to address any speech or hearing issues associated with the cleft palate
  • Long-term follow-up care may be necessary to monitor the success of the surgery and address any complications or concerns

What to Ask Your Doctor

  1. What is the success rate of grafts in patients with a history of cleft palate repair undergoing tympanoplasty?
  2. Are there any specific risk factors for tympanoplasty outcomes in patients with previous cleft palate repair?
  3. How does age impact the success of tympanoplasty in patients with cleft palate repair?
  4. What are the potential complications or risks associated with tympanoplasty in patients with a history of cleft palate repair?
  5. What are the expected hearing outcomes after tympanoplasty in patients with cleft palate repair?
  6. Are there any specific precautions or considerations that need to be taken for patients with a history of cleft palate repair undergoing tympanoplasty?
  7. How long is the recovery period expected to be for patients with cleft palate repair undergoing tympanoplasty?
  8. What post-operative care and follow-up appointments will be needed for patients with a history of cleft palate repair undergoing tympanoplasty?
  9. Are there any lifestyle changes or restrictions that need to be followed after tympanoplasty in patients with cleft palate repair?
  10. Are there any alternative treatment options or procedures that can be considered for patients with a history of cleft palate repair undergoing tympanoplasty?

Reference

Authors: Poupore NS, Smaily H, Carroll WW, Pecha PP. Journal: Otolaryngol Head Neck Surg. 2023 Jul;169(1):1-11. doi: 10.1177/01945998221118251. Epub 2023 Jan 27. PMID: 35943797