Repaired cleft palate and ventilation tubes and their associations with cholesteatoma in children and adults.

OBJECTIVE: To determine the influence of ventilation tubes (VTs) on the formation of cholesteatoma and hearing in operated cleft palate patients with chronic ear problems.

DESIGN: Retrospective 72-month follow-up of 116 operated cleft palate patients.

PATIENTS AND INTERVENTIONS: Demographic data, clinical examination, and hearing were evaluated. The patients were divided according to age and type of cleft and subdivided in a subgroup with (VT+) or without ventilation tube (VT-).

MAIN OUTCOME MEASURES: The effect of ventilation tubes (VT) on the incidence of cholesteatoma formation and degree of hearing loss in operated cleft palate patients with chronic ear problems.

RESULTS: The overall incidence of cholesteatoma was 15.5% (VT+, 14.0%; VT-, 16.7%; not significant). Bilateral hearing loss of >20 dB remained in 14.0% of the VT+ patients and in 22.7% of the VT- patients (p < .05). Submucous cleft palate (SM CP) adults (n = 15) developed high rates of cholesteatoma and hearing loss of >20 dB (both 26.7%).

CONCLUSIONS: Tube insertion had no influence on the development of cholesteatoma. Adults with submucous cleft palate especially require periodic otologic evaluation because they have Eustachian tube-related otologic disease and hearing loss at a higher rate than expected.