Wideband Tympanometry (WBT) Features in Children with Cleft Palate and Otitis Media with Effusion Before and After Cleft Palate Surgery

Abstract

Aims: In some cases, children with cleft palate undergo unnecessary tympanostomy along with palatoplasty because of inaccurate evaluations in determining the level of otitis media with effusion (OME). Recent studies have shown that wideband tympanometry (WBT) significantly contributes to the accurate evaluation of the middle ear status in children with cleft palate. Therefore, this study aimed to investigate WBT and auditory brainstem response (ABR) indices before and after cleft palate repair surgery.

Materials and methods: The study involved 88 children with cleft palate, and ABR and WBT energy absorbance indices were measured in two phases. The first phase was conducted three months and three days prior to cleft palate repair surgery, and the second phase was carried out one, three, and six months after surgery.

Results: In the first phase, the energy absorbance index of low frequencies was below the normal range in all children, within the normal range at high frequencies in 78 children, and below the normal range in only 10 children three months before cleft palate surgery. In the second phase, the energy absorbance index and hearing thresholds at low frequencies after surgery showed a significant difference compared with the preoperative index (p = 0.001).

Conclusion: Monitoring WBT indices and hearing thresholds in children with cleft palate is effective in determining the appropriate surgery for children with otitis media with effusion (OME). Furthermore, the WBT plays a crucial role in accurately assessing middle ear function after cleft palate surgery.

Fig. 1

Results of single and wideband tympanometry in right ear. (LF N (low frequency in normal range), LF LN (low frequency lower than normal range), HF N (high frequency in normal rane), HF LN(high frequency lower than normal range))

Fig. 2

Results of single and wide band tympanometry in left ear. (LF N (low frequency in normal range), LF LN (low frequency lower than normal range), HF N (high frequency in normal range), HF LN(high frequency lower than normal range))

Fig. 3

The results of wideband tympanometry of a 12-month-old child before and after cleft palate surgery. A: 3 months before cleft palate surgery, B: 3 days before cleft palate surgery, C: 3 month after cleft palate surgery, D: 6 month after cleft palate surgery