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					Middle ear effusion in patients with clefts
Dr. Wendy Kwan
Specialist, Department of Ear, Nose and Throat

Background: Cleft lip and/or palate is a common congenital anomaly in
Chinese. Western literature reported a very high incidence of otitis media with
effusion (OME) for cleft palate patients in their infancy. The incidence of glue
ear in Chinese cleft palate patients has not been reported in the literature

Objectives: To determine the incidence of OME and associated hearing loss,
the rate of ventilation tube insertion and complications of ventilation tube
insertion for glue ear in Chinese cleft palate patients.

Study Design: Retrospective study in a tertiary referral paediatric surgery

Methods: Case notes review of 104 consecutive patients with cleft lip and/or
cleft palate who were born after 1 January 1996 up to the one born on 2
January 2006.

Results: The incidence of glue ear in Chinese cleft palate patients for the first
2 years from birth was 76.1%. 13% of the glue ear episodes were associated
with a moderate hearing loss (>40dBHL). 53.2% of our patients had
ventilation tube insertion. Complications including retraction,
tympanosclerosis and perforation of tympanic membrane were found in 13.8%
of all glue ears

Conclusions: The high incidence of glue ear in cleft palate infants found in
this study is consistent with that reported in the western literature. A small but
significant proportion of glue ear was associated with moderate hearing loss
that warrants surgical treatment. Cleft palate children are much more likely to
develop glue ear than otherwise normal children and they develop glue ear at
an earlier age. A protocol for the treatment of glue ear in cleft palate patients
and further prospective randomised studies are warranted.

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