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Results of Myringoplasty in Children With Cleft Palate: A Patient-Matched Study

Harterink, Emilie*†; Leboulanger, Nicolas*; Kotti, Salma; Garabedian, Eréa-Noël*; Denoyelle, Françoise*

doi: 10.1097/MAO.0000000000000394
Pediatric Otology

Objectives: To assess the anatomic and functional outcome of underlay cartilage myringoplasty in children with cleft palate, at different postoperative periods compared with a patients-matched control group

Study Design: Case control study, tertiary referral center.

Methods: An otologic database was used to select children with cleft palate and perforated tympanic membrane who underwent myringoplasty between 1995 and 2012. These subjects were matched with control patients, without cleft palate, using the following criteria: age, size of perforation, status of contralateral ear, and status of middle ear mucosa. Charts were reviewed for the following: patients characteristics, preoperative findings, surgical data, postoperative anatomic and functional outcomes, and reinterventions. The postoperative findings were divided into 5 different periods.

Results: A group of 32 cleft palate patients as well as 32 control patients were included in this study, with a mean follow up of 63.6 ± 41 months. There were no differences between the groups in anatomic success as it was achieved in 84% in both groups. No differences were seen in functional outcome when compared with each different postoperative period. Using the last available audiogram, the postoperative mean air conduction and the air-bone gap were significantly worse in the cleft group compared with the control group, respectively, 26.1 ± 13.7 dB versus 18.4 ± 10.1 dB, p = 0.042; and 16.5 ± 9.4 dB and 11.3 ± 6.4 dB, p = 0.046. Additionally, the functional success was significantly worse in the cleft group; 58% versus 87% in the control group (OR, 5.5 [95% CI, 1.22–24.81], p = 0.027).

Conclusion: Children with cleft palate can benefit from cartilage underlay myringoplasty in terms of closure of tympanic membrane, although there is a worse functional outcome.

*Otolaryngology/Head and Neck Surgery department, Armand-Trousseau Children Hospital, Paris, France; †University Medical Center Utrecht, The Netherlands; and ‡Unité de Recherche Clinique de l’Est Parisien, AP-HP, Hôpital Saint Antoine, Paris, France

Address correspondence and reprint requests to Emilie Harterink, M.Sc., Justus van Effenstraat 1, 3511 HH, Utrecht, The Netherlands; E-mail: emilieharterink@gmail.com

Presented at the annual SFORL (Socíété Française d’ORL) congress, Paris, France, October 14, 2013.

The authors disclose no conflicts of interest.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company