Middle ear disease and eustachian tube function in patients with cleft palate.

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It has been well known that patients with cleft palate have a high incidence of middle ear disease. Etiology of the ear disease however is still obscure. Dysfunction of the eustachian tube which accompanied by cleft has been considered to be one of the etiological factors of frequent ear disease in cleft palate patient.To clarify the association between middle ear disease and eustachian tube, otological, endoscopical and functional studies of the eustachian tube were carried out in 263 cleft palate patients (526 ears).The results were as follows:1. Otitis media with effusion was most common (33%) in cleft palate cases, but neither the type of cleft, side of cleft nor velopharyngeal insufficiency had any correlation with the incidence of middle ear disease, suggesting that cleft palate patients had common pathological conditions to both eustachian tubes.2. A variety of abnormal movements were seen in pharyngeal orifices of the eustachian tube. More than half of them showed no dilation of the tube, indicating either hypofunction of the tensor muscle or abnormal pathway of the levator muscle.3. The mean opening pressure of the tube was lower in OME patients with cleft palate than those without cleft, indicating that decreased closing force was a pathogenic factor of OME in the cleft palate cases.4. Almost all ears of OME, and more than half of the normal ears in cleft palate patients could not equilibrate applied negative middle ear pressure during swallowing. Thus disturbance of dynamic ventilatory function of the tube seemed to be prevalent in the cleft palate cases, causing a high incidence of middle ear disease.5. Ciliary function of the tube in cleft palate patients was generally good with less etiologic significance.
耳鼻咽喉科臨床学会の論文

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田坂康之
京都大学医学部耳鼻咽喉科学教室

Middle ear disease and eustachian tube function in patients with cleft palate.

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