Analysis of the craniofacial skeleton in cleft children with otitis media with effusion

Various aspects have been proposed as the cause of otitis media with effusi on (OME) in cleft lip and/or palate (CL/P) populations (i.e. abnormal anato mic relation of Eustachian tube (ET) musculature and soft palate; the lack of intact palatal partition; reduction of nasal patency or chronic rhinitis ; timing and type of surgery). However, the role of deviated craniofacial s keleton (CFS) in CL/P has been neglected, although the role of the craniofa cial development on poor ET function has been advocated in non-cleft childr en. In this study, we evaluated clinical and cephalometric data of 37 Japan ese children with unilateral complete cleft lip and palate (UCLP, 25) or is olated cleft palate (ICP, 12) and compared them to 40 non-deft children, wh o were proportionally matched for age and sex. Data showed that OME was mor e often in children with unilateral cleft lip and palate-UCLP (76%) and tho se with isolated cleft palate-ICP (67%) than non-clefts (10.00%). In additi on to a number of skeletal abnormalities (i.e. short dimensions related to the posterior cranial base and backward and upward position of the maxilla) detected in CL/P cases, mastoid depth and height were also shorter in clef t cases than normal subjects. On the other hand, a small tendency to recurr ent upper airway infection (RUAI) was observed in cleft cases with OME. Fur ther, it was found that the following differences in the mastoid-middle ear -Eustachian tube (M-ME-ET) system were associated with a tendency to OME in UCLP cases: more horizontal ET in relation to the posterior cranial base; short bony ET; short height and antero-posterior depth of the mastoid air c ell system. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.