Does Palatoplasty Technique Impact Resolution of Eustachian Tube Dysfunction?

Monday, September 30, 2024

9:48 AM – 9:54 AM EDT

Location: MBCC, Art Deco 228AB

Disclosure(s):

Olivia L. Prosak, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kalpnaben R. Patel, CCRP:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan H. Belcher, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Children with cleft palate are comorbidly affected by eustachian tube dysfunction (ETD), with almost all children requiring ear tubes by the time of palatoplasty. There are multiple techniques to repair cleft palates but limited studies on the impact of these techniques on the improvement of ETD; this study is aimed to assess the impact of palatoplasty technique on postoperative ETD.

Methods: Children with non-syndromic cleft palate repaired at VUMC from 2005-2022 were evaluated in this retrospective cohort study. Patients with Veau classifications I-III and who underwent Furlow, 2-flap, or V-Y Pushback palatoplasty were included. All patients included underwent initial ear tube placement prior to or at the time of palate repair and were seen in follow-up at least 2 years out from palate repair.

Results: Of an initial 904 patients identified, 72 met all inclusion criteria and were preliminarily included. Patients were stratified into either Furlow or 2-flap/V-Y Pushback repair groups, which shared similar demographics and pre-op characteristics including repair age and weight, pre-op hearing results, and presence of middle ear fluid at time of initial ear tube placement. Patients with Veau I were more likely to undergo Furlow repair while those with Veau II or III underwent 2-flap or V-Y Pushback repair (p <.001). There was not a significant difference in postoperative ear tube placements between Furlow and 2-flap/V-Y Pushback palatoplasty groups, with both groups undergoing second and third sets at similar rates. Rates of VPI diagnoses, speech surgery, and adenoidectomy were not significantly different between surgical groups. A negative binomial regression model found that a lower Veau classification was a significant predictor of the number of post-operative ear tubes (p=.0143), but not repair type (p=.148).

Conclusions: Post-operative palatoplasty impact on ETD is a potentially useful indicator of the efficacy of the surgical approach, which could help dictate future surgical decision making. There was not a significant difference in effects of palate repair on ETD in this study’s preliminary data.

Presenting Author(s)

Olivia L. Prosak, BS

Medical Student
Vanderbilt University School of Medicine
Nashville, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

JD

Jennifer J. Du, BA

Medical Student
Vanderbilt University School of Medicine
Nashville, TN, United States

Disclosure information not submitted.
LG

Lily Gao, BA

Vanderbilt University School of Medicine, Tennessee, United States

Disclosure information not submitted.
Kalpnaben R. Patel, CCRP

Clin/Tran Research Coord III
Vanderbilt University Medical Center
Franklin, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
SZ

Shilin Zhao, PhD

Assistant Professor
Vanderbilt University Medical Center, USA

Disclosure information not submitted.

Senior Author(s)

Ryan H. Belcher, MD, MPH

Associate Professor, Vanderbilt Division of Pediatric Otolaryngology - HNS
Vanderbilt University
Nashville, TN, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.