Kazemi T, Nabavizadeh SS, Nadjmi N, Ahmadkhani A, Ghaemmaghami P, Kafaei A, Faramarzi A. The relationship between cleft palate repair technique and audiological outcomes: A retrospective cohort study.
Laryngoscope Investig Otolaryngol 2024;
9:e1237. [PMID:
38525123 PMCID:
PMC10960244 DOI:
10.1002/lio2.1237]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 03/26/2024] Open
Abstract
Objective
Otitis media with effusion is common in children with cleft palates. This study aimed to investigate the link between palatal closure techniques and audiological outcomes.
Methods
In this retrospective-prospective cohort study, we examined the relationship between palate repair techniques and hearing outcomes in children with cleft palates. From 2017 to 2022, 190 ears of 95 cleft patients were studied at the Cleft Lip and Palate Department of Shiraz University of Medical Sciences. Variables assessed included the surgical technique, cleft severity, auditory brainstem response (ABR) threshold, and tympanometry configuration.
Results
The mean ABR improved from a prepalatoplasty value of 39.51(11.62) decibels (dB) to a postpalatoplasty mean of 26.61(11.60) dB (Cohen's d: 1.12 [95% CI; 0.90-1.34]). Initially, 87.9% of the studied ears exhibited abnormal tympanometry, but this significantly decreased to 47% postsurgery (risk ratio: 4.43 [95% CI; 1.20-16.43]). When compared with Sommerlad intravelar veloplasty, the Nadjmi modified Furlow palatoplasty was associated with a notably lower mean ABR (β: -6.58 [95% CI: -10.43 to -2.73], p-value = .001) and a reduced frequency of abnormal tympanometry (odds ratio [OR]: -1.10; 95% CI: -1.85 to -0.36, p-value = .004). Factors like prepalatoplasty ABR, cleft palate severity, gender, and syndromic did not confound these findings.
Conclusions
Although the Nadjmi modified Furlow palatoplasty showed better results, our findings indicate a significant improvement in ABR and tympanometry outcomes for both techniques. Future randomized controlled trials are suggested to confirm the influence of palatal closure techniques on audiological outcomes.
Level of Evidence
3b.
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