Structure

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Author:
melihuff
ID:
13112
Filename:
Structure
Updated:
2010-04-04 23:07:32
Tags:
Cleft Palate
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Description:
Mod 12 Hearing Disorders in CP and related CF Anomalies
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  1. More than ? of newborns with cleft palate have fluid in the middle ear (ME)
    90%
  2. ME effusion is difficult to determine ?
    the degree of hearing loss
  3. hearing problem in cleft palate is generally?
    bilateral, conductive and in the mild to moderate range
  4. ME disease can also contribute to?
    high frequency hearing loss in patients with and without CP
  5. ___? is the most common problem
    Chronic Otitis Media with effusion (OME)
  6. OME fluctuating nature may cause?
    fluctuating hearing loss, baby/toddler gets unreliable auditory input
  7. 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
  8. ___ opens the eustachian tube, keeps it patent?
    Tensor veli palatini (TVP)
  9. 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
  10. ___ pulls lateral hooked cartilage away from wall of tube, keeping tube patent?
    Dilator tubae portion
  11. Negative ME pressure can?
    draw bacteria upward through tube and into ME cavity
  12. 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
  13. Ear disease in CP (2)?
    ETube obstruction

    Tube is "floppy"
  14. Tube more vertically orientated with growth
    better ? and less?
    drainage and disease
  15. Treatment of OME?
    Medical/medication

    Pressure equalization tubes (PE tubes)
  16. ___ persists weeks to months after medical treatment of the acute phase?
    MEE
  17. Earlier the onset of OME, more?
    chronic the disease
  18. Earlier placement of tubes associated with?
    better hearing and better otologic outcomes
  19. Variables that affect prevalence of ear disease:
    Type of cleft highest in?

    Age:
    CP +/- CL

    decrease with age of child
  20. 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
  21. Variables that affect prevalence of ear disease:

    Maxillary advancement:?

    Pharyngoplasty:?
    may benefit hearing in teenagers/adults

    no evidence of benefit
  22. 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
  23. Evidence of a direct relationship between Otitis media and language development ?
    does not exist
  24. 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
  25. Role of SLP:

    Promote and facilitate?
    early identification and referral, as well as routine f/u

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