Effects of Velopharyngeal Dysfunction on Middle Ear of Repaired Cleft Palate Patients

Objective: Cleft palates are strongly associated with the development of otitis media due to the anatomic and functional defect of the soft palate musculature and the associated alterations of velopharyngeal muscle insertion on tubal cartilage, or even intrinsic alterations of the cartilage, which affects eustachian tube function. This study will assess velopharyngeal muscle adequacy after palatoplasty through videonasoendoscopy and verify if there is a correlation with otologic status. Design: Transversal study. Setting: Otorhinolaryngology and cleft palate outpatient service of the Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, Brazil. Patients: Seventy-three patients with cleft palate or cleft lip and palate between the ages of 6 and 12 years who had already undergone palatoplasty. Interventions: Videonasoendoscopy for evaluation of velopharyngeal function and videotoscopy to assess middle ear status. Main Outcome Measures: Severity scale for videonasoendoscopic and videotoscopic findings. Results: There was no significant correlation between the videonasoendoscopic and the videotoscopic scores in the population studied. Discussion and Conclusions: Intrinsic defects of the eustachian tube cartilage and of the insertion of the velopharyngeal muscles seem to contribute to the evolution of otitis media in patients with cleft palate, in addition to the actual defect of the soft palate. There was no correlation between the severity of the otoscopic findings and the degree of velopharyngeal dysfunction.