Repaired Cleft Palate and Ventilation Tubes and Their Associations with Cholesteatoma in Children and Adults

Abstract

Objective: To determine the influence of ventilation tubes (VTs) on the formation of cholesteatoma and hearing in operated cleft palate patients with chronic ear problems. Design: Retrospective 72-month follow-up of 116 operated cleft palate patients. Patients and Interventions: Demographic data, clinical examination, and hearing were evaluated. The patients were divided according to age and type of cleft and subdivided in a subgroup with (VT+) or without ventilation tube (VT−). Main Outcome Measures: The effect of ventilation tubes (VT) on the incidence of cholesteatoma formation and degree of hearing loss in operated cleft palate patients with chronic ear problems. Results: The overall incidence of cholesteatoma was 15.5% (VT+, 14.0%; VT−, 16.7%; not significant). Bilateral hearing loss of >20 dB remained in 14.0% of the VT+ patients and in 22.7% of the VT− patients (p < .05). Submucous cleft palate (SM CP) adults (n  =  15) developed high rates of cholesteatoma and hearing loss of >20 dB (both 26.7%). Conclusions: Tube insertion had no influence on the development of cholesteatoma. Adults with submucous cleft palate especially require periodic otologic evaluation because they have Eustachian tube–related otologic disease and hearing loss at a higher rate than expected.