Middle Ear Pressure Disregulation in Cleft Palate Patients
| Status: | Completed |
|---|---|
| Conditions: | Cosmetic |
| Therapuetic Areas: | Dermatology / Plastic Surgery |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 2/20/2019 |
| Start Date: | August 2006 |
| End Date: | May 22, 2017 |
Middle Ear Pressure Disregulation in Cleft Palate Patients: Form-Function Correlates
The investigators know that middle-ear disease is very common in infants with cleft palate
and causes hearing loss that can last into childhood. It is thought that a poor ability to
keep the pressure in the middle ear at a similar level to that in the environment causes
middle-ear disease and that this depends on the opening function of a natural tube that
connects the back of the nose with the middle ear, called the Eustachian tube. The
investigators believe that the middle-ear disease in cleft palate infants and children is
caused by poor Eustachian tube function that in turn is caused by anatomical problems in the
muscles that open the tube. The investigators plan to test these relationships by studying
the changes between 5-24 months and 6 years in middle-ear health, the way the Eustachian tube
works and Eustachian tube anatomy in cleft palate children.
and causes hearing loss that can last into childhood. It is thought that a poor ability to
keep the pressure in the middle ear at a similar level to that in the environment causes
middle-ear disease and that this depends on the opening function of a natural tube that
connects the back of the nose with the middle ear, called the Eustachian tube. The
investigators believe that the middle-ear disease in cleft palate infants and children is
caused by poor Eustachian tube function that in turn is caused by anatomical problems in the
muscles that open the tube. The investigators plan to test these relationships by studying
the changes between 5-24 months and 6 years in middle-ear health, the way the Eustachian tube
works and Eustachian tube anatomy in cleft palate children.
Otitis media with effusion (OME) is recognized as nearly universal in the population of
infants and children with cleft palate (CP) and is often associated with long-standing
conductive and, perhaps, sensorineural hearing losses. Most evidence suggests that OME in CP
patients is a complication of inefficient Eustachian tube function (ETF). The investigators
plan to use our most complete tests to characterize ETF in CP infants tested at age 5-24
months and followed up through age 6 years by yearly collection of clinical data for the
presence/absence of OME and repeat ETF testing. To obtain anatomical data, the investigators
will obtain basal and lateral cephalograms at age 3 years in all subjects and perform MRI
tests prepalatoplasty when possible and then at 3 and 5 years on a subset of the enrolled
children. Functional-anatomical reconstructions based on the MRI data will be studied for the
mechanical interactions underlying the phenomenon of ET constriction in CP patients and
examined for the possibility of surgical interventions to correct identified abnormal
interactions.
infants and children with cleft palate (CP) and is often associated with long-standing
conductive and, perhaps, sensorineural hearing losses. Most evidence suggests that OME in CP
patients is a complication of inefficient Eustachian tube function (ETF). The investigators
plan to use our most complete tests to characterize ETF in CP infants tested at age 5-24
months and followed up through age 6 years by yearly collection of clinical data for the
presence/absence of OME and repeat ETF testing. To obtain anatomical data, the investigators
will obtain basal and lateral cephalograms at age 3 years in all subjects and perform MRI
tests prepalatoplasty when possible and then at 3 and 5 years on a subset of the enrolled
children. Functional-anatomical reconstructions based on the MRI data will be studied for the
mechanical interactions underlying the phenomenon of ET constriction in CP patients and
examined for the possibility of surgical interventions to correct identified abnormal
interactions.
Inclusion Criteria:
- birth-24 months
- unrepaired or recently repaired cleft palate
Exclusion Criteria:
- cleft palate associated with syndrome
- known immune deficiency
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