COMPLICATIONS OF THE MIDDLE-EAR IN TEENAG ERS AFTER SURGICAL-TREATMENT OF CLEFT PALATES

We examined two groups of teenagers who had been surgically treated as small children for cleft palate. Most patients were between 13 and 21 years of age. One group had been looked after by the Dept. of Orthodo ntics at the University of Erlangen-Nurnberg, the other by the Dept. o f Orthodontics at the University of Rostock. There were differences in sequence and time of the surgical closure between the two departments . Additionally, 60 % of the people treated in Rostock had a velopharyn goplastic, which was rarely the case in Erlangen. In both groups only a few patients had been seen by an ENT-doctor regularly. Only some pat ients had been previously treated with tubes. There was one patient in each group with a bilateral, most likely genetically determined, sens orineural hearing loss. In Erlangen we examined 66 teenagers (132 ears ). Six ears had been previously treated with one or more tympanoplasti es. 10 ears needed further treatment due to a seromucotympanon, adhesi ons, perforations of the ear drum, suspicion of cholesteatoma or insuf ficient improvement of hearing after previous tympanoplasty. Another 1 8 ears showed signs of former inflammations. The control group in Rost ock included 63 patients (i.e. 126 ears). 14 of the ears examined had undergone one or more tympanoplasties previously. 13 other ears needed further treatment for seromucotympanon, adhesions, perforations of th e ear drum, insufficient improvement of hearing after tympanoplasty or cholesteatoma. Residuals due to prior inflammations were found in ano ther 26 ears. Possible reasons for the different occurrence of middle ear problems in both groups are discussed.