First symptoms of secretory otitis media in newborns operated for cleft defect in a ten-year group

Czech version

Authors: M. Jurovčík ¹; J. Borský ¹; P. Dytrych ¹; Michal Černý ³; J. Velemínská ⁴; L. Jaklová ⁴; K. Kotaška ²; L. Hanousková ²; J. Skřivan ¹
Authors‘ workplace: Klinika ušní, nosní a krční 2. LF UK a FN v Motole, Praha ¹; Ústav lékařské chemie a klinické biochemie 2. LF UK a FN v Motole, Praha ²; Novorozenecké oddělení FN v Motole, Praha ³; Katedra antropologie a genetiky člověka, Přírodovědecká fakulta UK, Praha ⁴
Published in: Otorinolaryngol Foniatr, 69, 2020, No. 2, pp. 55-61.
Category: Original Article

Overview

Introduction: Almost all patients with cleft palate suffer from Eustachian tube insufficiency.The result is usually the development of otitis media with effusion. Its first manifestation can be observed in newborns. The aim of this work is to detect the first symptoms of the disease during the first phase of the surgical solution - the primary suture of the lip, which we perform in neo-neonatal age. Another goal is to evaluate the value of objective audiological methods in relation to the diagnosis of middle ear fluid.

Material and methods: In a ten-year period, a group of 314 patients with cleft defects were evaluated, who had primary lip suture in the neonatal period. Prior to the procedure, OAE, standard 226 Hz and high frequency 1000 Hz tympanometry were examined. However, it was not possible to complete all examinations in all patients. In case of suspicion of presence of middle ear secretion, otomicroscopy with diagnostic paracentesis was performer.

Results: Over ten years, lip surgery was performed in 314 newborns, 241 to 7 days of age. Most patients (57) were operated on the third postpartum day. 178 patients had cleft lip and palate, 136 patients had cleft lip. A total of 394 ears with a 1000 Hz probe and a 408 standard 226 Hz probe were examined. Middle ear fluid was detected in 74% of patients with cleft palate (unilaterally or bilaterally). The middel ear fluid appeared regularly on the non-cleft side, where the tubular torus was normally morphologically configured. In 96% the result of 1000 Hz tympanometric examination (B curve) coincided with the finding of middle ear fluid.

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 secretion does not depend on the cleft side. High-frequency tympanometry is a highly conclusive method for determining the presence of middle ear fluid in newborns.

Keywords:

newborns – otitis media with effusion – cleht palate

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