Cartilage tympanoplasty in children with cleft palate repair.

Objective: To determine outcomes of type 1 cartilage tympanoplasty in a cohort of pediatric patients with a history of cleft palate repair.
Patients and Outcome Measures: Retrospective chart review and comparison with a historical control group of patients with no cleft palate anomaly undergoing the same procedure by the same surgeon at a tertiary care pediatric hospital. A total of 37 patients between ages 4 and 19 years inclusive (45 ears), with a history of repaired cleft palate, underwent type 1 cartilage tympanoplasty with or without primary tube insertion from September 2004 to October 2012. Demographics, type of cleft palate, surgical indication, middle ear status, complications, history of myringotomy tube insertion, and auditory outcomes were collected. Results were compared with those for a non-cleft palate cohort that had undergone the same procedure, which had been previously published.
Results: The unadjusted average preoperative and postoperative pure-tone averages for patients with a history of cleft palate were 22.06 and 7.29, respectively, compared with 18.34 and 8.32, respectively, for non-cleft patients. Despite significantly worse preoperative hearing levels among the cleft palate group, there was no statistically significant difference in outcomes with regard to hearing results between the two groups. One patient in the cleft palate group required revision type 1 cartilage tympanoplasty for graft failure, which is comparable to that reported for non-cleft palate patients. Post-tympanoplasty secondary tympanostomy intubation was slightly higher for the cleft palate population.
Conclusion: Type 1 cartilage tympanoplasty, when performed in a pediatric population with a history of cleft palate, can achieve closure and hearing results that are comparable of those in patients with no such anomaly.