Traci Flynn

The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts

OBJECTIVES Children with cleft lip and palate universally present with otitis media with effusion. This prevalence has not been systematically studied. The purpose of the present study was to examine and compare the prevalence of otitis media with effusion, hearing sensitivity, and audiometry method utilised for assessment in children with and without clefts. METHODS Two groups of children (children with unilateral cleft lip and palate, N=22, and children without clefts, N=20) were followed prospectively and longitudinally from 1 to 5 years of age. Data were collected at four points (1, 1.5, 3, and 5 years of age). Assessments at each of the four points included: (1) otomicroscopy, (2) tympanometry, and (3) hearing assessment. RESULTS Overall the children with unilateral cleft lip and palate demonstrated a significantly higher prevalence of otitis media with effusion (121 ears, 74.7%) than children without clefts (31 ears, 19.4%) (p<0.001). This higher prevalence was also significant at 1, 1.5, 3, and 5 years of age (p<0.001). Of those ears with otitis media with effusion, 83.1% of the ears exhibited a hearing loss (PTA >20 dB), with this loss more prevalent in the cleft group (89.7% UCLP and 70.0% non-cleft). The hearing loss was significantly more pronounced in the cleft (group 35.71 dB HL UCLP and 26.41 dB HL non-cleft group). Children with unilateral cleft lip and palate utilised a lower age-appropriate audiometry testing method than age-matched children with no cleft at 1, 1.5, and 3 years of age. CONCLUSIONS Children with unilateral cleft lip and palate present with a significantly higher prevalence of otitis media with effusion than children without cleft. Also, the hearing loss associated with otitis media with effusion is demonstrated in this study. Furthermore, the method of audiometry has been examined and children with unilateral cleft lip and palate had to be assessed with a lower level of method than children without cleft.

A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate

To study longitudinal prevalence of otitis media with effusion (OME) in children between 7 and 16 years of age by cleft group, and hearing sensitivity across time and across frequencies.

A longitudinal study of hearing and middle ear status in individuals with UCLP.

Objective To define the age when the higher prevalence of abnormal middle ear dissipates in individuals with cleft lip and palate and to investigate how this may affect hearing sensitivity over time. Study Design Retrospective and prospective cohort study. Setting University hospital. Patients Three groups of individuals with unilateral cleft lip and palate from the same cleft center: 1) a group of individuals followed longitudinally from 1 to 5 years of age (n = 22), 2) another group of individuals followed longitudinally from 7 to 16 years of age (n = 24), and 3) a group which encompasses young adults between 20 and 31 years of age (n = 26). Main Outcomes Measure(s) Abnormal middle ear status and hearing sensitivity. Results The prevalence of abnormal middle ear status decreases as the individuals within the 3 groups age from 89% at age 1 year to 10% in young adulthood. Hearing statistically improved as children became older up to 13 years of age and then worsened in the high frequencies between 16 and 20 to 31 years of age. Conclusion There is a high prevalence of abnormal middle ear status in individuals with cleft lip and palate. This higher prevalence of abnormal middle ear status may lead to poorer high-frequency hearing, which could potentially lead to challenges in academics and difficulties understanding speech in social situations. Further investigation into these, the prevalence of abnormal middle ear status and hearing in comparison to a control group is warranted.

Phonology in Swedish-speaking 3-year-olds born with cleft lip and palate and the relationship with consonant production at 18 months.

BACKGROUND Approximately 50% of children born with cleft palate present speech difficulties around 3 years of age, and several studies report on persisting phonological problems after palatal closure. However, studies on early phonology related to cleft palate are few and have so far mainly been carried out on English-speaking children. Studies on phonology related to cleft palate in languages other than English are also warranted. AIMS To assess phonology in Swedish-speaking children born with and without unilateral cleft lip and palate (UCLP) at 3 years of age, and to identify variables at 18 months that are associated with restricted phonology at age 3 years. METHODS & PROCEDURES Eighteen consecutive children born with UCLP and 20 children without cleft lip and palate were included. Transcriptions of audio recordings at 18 months and 3 years were used. Per cent correct consonants adjusted for age (PCC-A), the number of established phonemes, and phonological simplification processes at 3 years were assessed and compared with different aspects of consonant inventory at 18 months. OUTCOMES & RESULTS PCC-A, the number of established phonemes, and the total number of phonological processes differed significantly at 3 years between the two groups. Total number of oral consonants, oral stops, dental/alveolar oral stops and number of different oral stops at 18 months correlated significantly with PCC-A at 3 years in the UCLP group. CONCLUSIONS & IMPLICATIONS As a group, children born with UCLP displayed deviant phonology at 3 years compared with peers without cleft lip and palate. Measures of oral consonant and stop production at 18 months might be possible predictors for phonology at 3 years in children born with cleft palate.

Hearing and otitis media with effusion in young adults with cleft lip and palate.

Abstract Conclusion: Speech recognition in noise is affected when otitis media with effusion (OME) is present in young adults with unilateral cleft lip and palate. Objective: The objective of this study was to describe the hearing and performance on auditory tasks of young adults with unilateral cleft lip and palate as compared to young adults without cleft lip and palate. Methods: Twenty-six young adults with unilateral cleft lip and palate and 23 young adults without cleft lip and palate participated in the study. Pure tone audiometry, tympanometry, speech recognition in noise at the word and sentence level, and masking level difference were examined. Results: Results revealed elevated hearing thresholds in the young adults with cleft lip and palate as compared with young adults without cleft lip and palate. No differences concerning speech recognition in noise and binaural processing were observed between the young adults with cleft lip and palate and those without. However, there was poorer speech recognition performance in those adults with unilateral cleft lip and palate and OME on the day of testing as compared with young adults with unilateral cleft lip and palate without OME on the day of testing.

A Longitudinal Study of Hearing and Middle Ear Status of Individuals With Cleft Palate With and Without Additional Malformations/Syndromes

Objective To describe and compare the middle ear status and hearing sensitivity in adolescence with isolated cleft palate plus additional malformations and/or syndromes with those with only an isolated cleft palate. Design Retrospective and longitudinal. Two groups of individuals with isolated cleft palate were compared. Participants A cohort of individuals born over 4 years in the western region of Sweden. The cohort was divided into one group with isolated cleft palate (n = 31; ICP) and one group with isolated cleft palate plus additional malformations and/or syndromes (n = 37; ICP+). Methods Middle ear status and hearing thresholds were collected from the medical records at 7, 10, 13, and 16 years of age, examined, and compared within and between groups over time. Results The ICP+ group demonstrated a significantly higher prevalence of abnormal middle ear status and elevated hearing thresholds as compared with the ICP group. As the individuals aged, the prevalence of abnormal middle ear status decreased. The hearing levels in both groups decreased in the low to middle frequencies as individuals aged; however, the hearing in the high frequencies did not. Conclusions Individuals with cleft palate need to be followed routinely for middle ear status and hearing thresholds to ensure optimal audiological rehabilitation, with particular attention to those with additional malformations and/or syndromes.

ABR thresholds in infants born with CLP and OME and infants with OME

OBJECTIVES The aim of this study was to investigate and compare auditory brainstem response (ABR) thresholds related to otitis media with effusion (OME) in infants with and without cleft palate and/or lip (CP±L). METHODS Forty-seven infants with CP±L and 67 infants with OME participated in the study. Hearing thresholds of ears of infants with OME were compared between groups and within the group with CP±L. RESULTS Infants with CP±L and OME presented with similar hearing thresholds as infants with OME and not CP±L. Within the cleft group, infants with isolated cleft palate and OME demonstrated significantly higher hearing thresholds than infants with unilateral cleft lip and palate and OME. CONCLUSION A high prevalence of infants with CP±L present with OME early in life. Hearing thresholds of these infants are similar to infants without CP±L, but with OME. The ear status and hearing thresholds of infants with CP±L needs to be monitored to be able to provide the best access to hearing in order to fully allow speech and language development.

Comprehensive handbook of pediatric audiology - second edition

ISSN: 1499-2027 (Print) 1708-8186 (Online) Journal homepage: http://www.tandfonline.com/loi/iija20 Comprehensive handbook of pediatric audiology second edition Traci Flynn To cite this article: Traci Flynn (2016): Comprehensive handbook of pediatric audiology second edition, International Journal of Audiology, DOI: 10.1080/14992027.2016.1195020 To link to this article: http://dx.doi.org/10.1080/14992027.2016.1195020