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More than ? of newborns with cleft palate have fluid in the middle ear (ME)
90%
ME effusion is difficult to determine ?
the degree of hearing loss
hearing problem in cleft palate is generally?
bilateral, conductive and in the mild to moderate range
ME disease can also contribute to?
high frequency hearing loss in patients with and without CP
___? is the most common problem
Chronic Otitis Media with effusion (OME)
OME fluctuating nature may cause?
fluctuating hearing loss, baby/toddler gets unreliable auditory input
Eustachian tude (ET) function has 3 main functions?
Aerates middle ear
Provides for atmospheric-ME pressure equalization
Provides for fluid drainage from ME into nasopharynx
___ opens the eustachian tube, keeps it patent?
Tensor veli palatini (TVP)
Dilator tubae = ?
pulls on the lateral (hooked) cartilage of the tube and opens the pharyngeal orifice of the ET
lower bundle of Tensor veli palatini
___ pulls lateral hooked cartilage away from wall of tube, keeping tube patent?
Dilator tubae portion
Negative ME pressure can?
draw bacteria upward through tube and into ME cavity
Horizontal orientation of ET in infant
Decrease:
__ not ventilated __ pressure
___ retracted
___ develops
____ drawn upward
tensors ability to open it
not ventilated (-) pressure
TM
Effusion (ME fluid)
Bacteria
Ear disease in CP (2)?
ETube obstruction
Tube is "floppy"
Tube more vertically orientated with growth
better ? and less?
drainage and disease
Treatment of OME?
Medical/medication
Pressure equalization tubes (PE tubes)
___ persists weeks to months after medical treatment of the acute phase?
MEE
Earlier the onset of OME, more?
chronic the disease
Earlier placement of tubes associated with?
better hearing and better otologic outcomes
Variables that affect prevalence of ear disease:
Type of cleft highest in?
Age:
CP +/- CL
decrease with age of child
Variables that affect prevalence of ear disease:
Effects of palatoplasty:?
___ may benefit ear health?
No evidence that shows OME decrease due to palatoplasty
Levator retrodisplacement
Variables that affect prevalence of ear disease:
Maxillary advancement:?
Pharyngoplasty:?
may benefit hearing in teenagers/adults
no evidence of benefit
Hearing Evaluations:
Testing should be coordinated with?
Should always?
team visits:
Tympanometry and immitance testing
F/u through adolescence
be done pre and post op myringotomy and tubes
Evidence of a direct relationship between Otitis media and language development ?
does not exist
Role of SLP
Provide ?
info on the relationship between OME and probable effects on speech and language acquisition
E.g. effects on speech sound learning
auditory attention
early language development
Role of SLP:
Promote and facilitate?
early identification and referral, as well as routine f/u
Author
melihuff
ID
13112
Card Set
Structure
Description
Mod 12 Hearing Disorders in CP and related CF Anomalies
Updated
2010-04-05T03:07:32Z
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