Search PubMedSearch

PubMed · 6541954

Middle ear function in cleft palate.

Abstract

This study is based on an impedence audiometric evaluation of three groups of patients-20 with un-operated cleft palate, 28 normal subjects as controls and 20 operated cleft palate patients. Four major parameters have been analysed: middle ear pressure, static compliance, acoustic reflex and tympanometry. It was confirmed that in the normal child Eustachian tube function improves with growth and the critical age when the middle ear pressure becomes normal in almost all the normal children is 5 to 6 years. This process of improvement is disturbed in the presence of a cleft palate. Poor Eustachian tube function, evidenced by persistent negative middle ear pressure, continues to be commonly seen in the older subjects with un-operated cleft palates. The static compliance that reflects the elasticity of the conducting mechanism of the middle ear is poorer in cleft palate patients. It was also observed that when the cleft palate had been repaired before the age of 6 years, Eustachian tube function improved significantly in the older age group as shown by the lower incidence of negative middle ear pressure and Eustachian tube block. The high incidence of serous otitis media is apparently unaffected by surgery on the cleft palate and is responsible for some degree of hearing loss encountered in the older patients with operated cleft palates. Thus the incidence of hearing loss as studied by acoustic reflex is higher in all age groups in the presence of a cleft palate.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

A Gopalakrishna, K S Goleria, A Raje. 1984. Middle ear function in cleft palate.. https://doi.org/10.1016/0007-1226(84)90149-8

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Otoneurologic evaluation of child vertigo.

In this study 282 children with vertigo are subdivided (according to previous experiences) into three large groups: (1) vertigo and cochlear diseases; (2) vertigo as an isolated symptom; and (3) vertigo and C.S.N. diseases. Due to the difficult etiopathogenetic investigation of the patients from the second group, the authors focused on that group as they are less studied, are without associated symptoms (deafness--first group; CNS diseases--second group) and where vertigo appears as an idiopathic and an isolated symptom. A careful anamnestic, clinical and instrumental analysis leads to the following observations: (1) in decreasing order of frequency we find the third group, followed by the first and finally by the second; (2) in spite of the overall lower incidence of the second group, this latter includes the paroxismal benign vertigo (PBV) which is overall the second most frequent vertiginous form (after vertigo due to cranial trauma). In this group the authors underline the reasonably high incidence of the iatrogenic syndromes, insisting on the need of their accurate prevention of these risks; (3) the authors confirm that, nowadays, a reliable etiopathogenetic cause of the apparently isolated vertigo (except for the ascertained iatrogenic forms) cannot be identified. Moreover, in spite of its frequency, PBV is the less known form of vertigo, of which we cannot give a certain diagnosis and which can be identified only the the exclusion of all the other known forms through instrumental and clinical observations.

Acoustic Impedance Tests

Neurophysiological evaluation of acute facial paralysis in children.

Objective evaluation of facial nerve paralysis represents a unique challenge to the clinician. Electroneurography (ENoG) and the acoustic reflex (AR) have been widely used as neurophysiological tests in an assessment of facial nerve function. However, ENoG or AR alone does not suffice diagnostic and prognostic purposes of facial function evaluation in children. To further investigate the diagnostic aspects of facial nerve paralysis, the prognostic value of AR and ENoG, and the time course of the disease in pediatric population, a series of 30 children with acute facial paralysis were investigated by correlation of findings from video-taped House-Brackmann facial grading system. AR and ENoG. The results showed that AR was absent or abnormal for thresholds in 68.2% of patients with Bell's palsy and normal middle ear function. Shorter duration and higher percentage of recovery were found in the children with a normal AR than those with an abnormal AR. Three children showed an abnormal tympanogram and hearing loss associated with acute facial paralysis. These findings should alert the clinician to the presence of a specific, treatable disease in the evaluation of Bell's palsy. The percentage of electroneurographic response varied with different days after onset. ENoG showed minimal responses at weeks 1 3 after onset of Bell's palsy in most patients. The study of the time-course in the children with Bell's palsy demonstrated a functional gap in the early (< 1 week) and late clinical stage (after 6 weeks) of the disease, suggesting that ENoG predicted well only during weeks 1-4 after onset. In general, ENoG showed a good recovery in children, however, recurrent Bell's palsy becomes a concern. The need for neurophysiological follow-up for possible incomplete recovery of the facial nerve is emphasized. It is recommended that AR and ENoG should be included in the diagnostic workup when evaluating pediatric facial function.

Acoustic Impedance Tests

Hearing impairment and otitis media in a rural primary school in south India.

In order to determine the prevalence of hearing impairment and otitis media in rural primary school children, a pilot study of 284 children aged 6-10 years was performed. These children were screened by otoscopy, pure tone audiometry and tympanometry. The overall prevalence of otological abnormalities (excluding wax) was 21.5%. Hearing impairment was detected in 34 children (11.9%). Conductive hearing impairment was predominant (10.9%). Otitis media was diagnosed in 17.6% of children. While 91.2% of children with hearing impairment had associated middle ear disease, only 53.4% of those with middle ear disease were detected as have hearing impairment. The importance of including tympanometry as part of the screening protocol is highlighted.

Acoustic Impedance Tests