Effect of Hamulotomy on Middle Ear Pressure and Eustachian Tube Dysfunction in Children With Cleft Palate: A Randomized Controlled Trial.

Abstract

BackgroundHamulotomy is a surgical procedure primarily performed during palatoplasty procedure in cleft children. This study aims to explore the effects of hamulotomy on middle ear pressure and eustachian tube dysfunction, a critical factor in maintaining proper ear function and hearing.Material and MethodologyA total of 24 patients under the age of 3 were recruited for the study and underwent primary palatoplasty. Patients were assigned randomly to either have hamulotomy or not have hamulus fracture preoperatively. Middle ear pressure, ear canal volume, compliance, reflex, and eustachian tube function was assessed pre- and post-operatively in patients undergoing primary palatoplasty using impedance audiometry. Data were analyzed using the Wilcoxon signed rank test, McNemar's change test, and Mann-Whitney U test, with a significance level set at P ≤ 0.05.ResultsOtoscopy revealed that there was no significant difference in the improvement of middle ear status between the groups. Additionally, there was no significant difference in impedance audiometry results in either group. However, the test revealed that middle ear peak pressure in cleft children ranged from -324 to 375 dapa, and 58% of cleft children exhibited a type B tympanogram.ConclusionsHamulotomy does not appear to have a significant effect on middle ear pressure changes suggesting its safe use in palatoplasty without increasing the risk of middle ear dysfunction. Given the potential benefits of Hamulotomy in improving surgical access, tension free closure during palatoplasty, its use can be considered a viable option, with minimal concern for adverse effects on middle ear function.