The first symptoms of secretory otitis in newborns operated for cleft palate – capture in a ten-year cohort
Abstract
Introduction: Almost all patients with cleft palate suffer from Eustachian tube insufficiency. The result is usually the development of secretory otitis.
Its first manifestations can be observed in newborns. The aim of the work is to capture the first symptoms of the disease in the first phase of the surgical solution - the primary suture of the lip, which we perform in the neonatal period.
Another goal is to evaluate the informative value of objective audiological methods in relation to the diagnosis of middle ear secretion. Material and methods: In a ten-year period, a group of 314 patients with cleft palate who underwent primary lip suturing in the neonatal period was evaluated.
Before the procedure, OAE, standard 226 Hz and high-frequency 1,000 Hz tympanometry were examined. Not all patients were able to perform all examinations at the same time.
In case of suspicion of the presence of middle ear secretion, otomicroscopy was performed with diagnostic paracentesis and possible aspiration of secretion. Results: During ten years, primary lip suturing was performed in 314 newborns, 241 of them by the seventh day of age.
Most patients (59) underwent surgery on the third postpartum day. 178 patients had cleft lip and palate at the same time, 136 only cleft lip. A total of 394 ears were examined with a 1,000 Hz probe and 408 with a standard 226 Hz probe.
Middle ear secretion was detected in 74% of patients with cleft palate (unilaterally or bilaterally). The secretion also appeared regularly on the non-cleft side, where the tubal torus was normally morphologically configured.
In 96%, the result of the 1,000 Hz tympanometric examination (B curve) coincided with the finding of secretion. Conclusion: Middle ear secretion was detected in newborns, but only in those who had cleft palate.
In all patients with isolated cleft lip, the middle ear was airy. The presence of a secretion does not depend on the side of the cleft.
High-frequency tympanometry is a highly significant method for determining the presence of middle ear secretion in newborns.