Internationally adopted children with cleft lip and/or cleft palate: Middle ear findings and hearing during childhood

Int J Pediatr Otorhinolaryngol. 2018 Aug:111:47-53. doi: 10.1016/j.ijporl.2018.05.019. Epub 2018 May 19.

Abstract

Objective: Adopted children with cleft lip and/or cleft palate form a diverse group of patients. Due to increased age at palatal repair, adopted children have a higher risk of velopharyngeal insuffiency and poor speech outcome. Delayed palate repair may also lead to longer lasting Eustachian tube dysfunction. Decreased function of the Eustachian tube causes otitis media with effusion and recurrent acute otitis media, which can lead to other middle ear problems and hearing loss.

Methods: One-hundred-and-thirty-two adopted children treated by the Cleft palate team in Wilhelmina Children's Hospital during January 1994 and December 2014 were included. Retrospectively, middle ear findings, the need for ventilation tube insertion and hearing during childhood were assessed. Findings were compared with 132 locally born children with cleft lip and/or cleft palate.

Results: Adopted children had a mean age of 26.5 months old when they arrived in our country. After the age of two the total number of otitis media with effusion episodes and the need for ventilation tube placement did not significantly differ among adopted and non-adopted children. Adopted children had significantly more tympanic membrane perforations. Hearing threshold levels normalized with increasing age. Although within normal range, adopted children showed significantly higher pure tone averages than locally born children when they were eight to ten years old.

Conclusion: In general, adopted patients with cleft lip and/or cleft palate did not have more middle ear problems or ventilation tubes during childhood. However, theyhave more tympanic membrane perforations.

Keywords: Cleft lip and/or cleft palate; Hearing; Otitis media with effusion; Ventilation tubes.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Adopted*
  • Child, Preschool
  • Cleft Lip / complications*
  • Cleft Lip / surgery
  • Cleft Palate / complications*
  • Cleft Palate / surgery
  • Female
  • Follow-Up Studies
  • Hearing Loss / diagnosis
  • Hearing Loss / epidemiology
  • Hearing Loss / etiology*
  • Hearing Tests
  • Humans
  • Male
  • Middle Ear Ventilation / statistics & numerical data
  • Netherlands
  • Otitis Media with Effusion / diagnosis
  • Otitis Media with Effusion / epidemiology
  • Otitis Media with Effusion / etiology*
  • Otitis Media with Effusion / surgery
  • Retrospective Studies
  • Speech Disorders / complications
  • Tympanic Membrane Perforation / diagnosis
  • Tympanic Membrane Perforation / epidemiology
  • Tympanic Membrane Perforation / etiology*