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melihuff
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More than ? of newborns with cleft palate have fluid in the middle ear (ME)
90%
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ME effusion is difficult to determine ?
the degree of hearing loss
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hearing problem in cleft palate is generally?
bilateral, conductive and in the mild to moderate range
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ME disease can also contribute to?
high frequency hearing loss in patients with and without CP
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___? is the most common problem
Chronic Otitis Media with effusion (OME)
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OME fluctuating nature may cause?
fluctuating hearing loss, baby/toddler gets unreliable auditory input
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Eustachian tude (ET) function has 3 main functions?
Aerates middle ear
Provides for atmospheric-ME pressure equalization
Provides for fluid drainage from ME into nasopharynx
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___ opens the eustachian tube, keeps it patent?
Tensor veli palatini (TVP)
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Dilator tubae = ?
pulls on the lateral (hooked) cartilage of the tube and opens the pharyngeal orifice of the ET
lower bundle of Tensor veli palatini
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___ pulls lateral hooked cartilage away from wall of tube, keeping tube patent?
Dilator tubae portion
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Negative ME pressure can?
draw bacteria upward through tube and into ME cavity
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Horizontal orientation of ET in infant
Decrease:
__ not ventilated __ pressure
___ retracted
___ develops
____ drawn upward
tensors ability to open it
- not ventilated (-) pressure
- TM
- Effusion (ME fluid)
- Bacteria
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Ear disease in CP (2)?
ETube obstruction
Tube is "floppy"
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Tube more vertically orientated with growth
better ? and less?
drainage and disease
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Treatment of OME?
Medical/medication
Pressure equalization tubes (PE tubes)
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___ persists weeks to months after medical treatment of the acute phase?
MEE
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Earlier the onset of OME, more?
chronic the disease
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Earlier placement of tubes associated with?
better hearing and better otologic outcomes
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Variables that affect prevalence of ear disease:
Type of cleft highest in?
Age:
CP +/- CL
decrease with age of child
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Variables that affect prevalence of ear disease:
Effects of palatoplasty:?
___ may benefit ear health?
No evidence that shows OME decrease due to palatoplasty
Levator retrodisplacement
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Variables that affect prevalence of ear disease:
Maxillary advancement:?
Pharyngoplasty:?
may benefit hearing in teenagers/adults
no evidence of benefit
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Hearing Evaluations:
Testing should be coordinated with?
Should always?
- team visits:
- Tympanometry and immitance testing
- F/u through adolescence
be done pre and post op myringotomy and tubes
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Evidence of a direct relationship between Otitis media and language development ?
does not exist
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Role of SLP
Provide ?
info on the relationship between OME and probable effects on speech and language acquisition
- E.g. effects on speech sound learning
- auditory attention
- early language development
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Role of SLP:
Promote and facilitate?
early identification and referral, as well as routine f/u
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