{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T03:41:51Z","timestamp":1784259711553,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T00:00:00Z","timestamp":1493683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Describe the impact of hearing loss, tympanostomy tube placement before palatoplasty, and number of tubes received on speech outcomes in children with cleft palate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care children\u2019s hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Records from 737 children born between April 2005 and April 2015 who underwent palatoplasty at a tertiary children\u2019s hospital were reviewed. Exclusion criteria were cleft repair at an outside hospital, intact secondary palate, absence of postpalatoplasty speech evaluation, sensorineural or mixed hearing loss, no tubes, first tubes after palatoplasty, or first clinic after 12\u00a0months of age. Data from 152 patients with isolated cleft palate and 166 patients with cleft lip and palate were analyzed using Wilcoxon rank\u2010sum, \u03c7<jats:sup>2<\/jats:sup>, and Fisher exact test and logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most patients (242, 76.1%) received tubes before palatoplasty. Hearing loss after tubes, but not before, was associated with speech\/language delays at 24\u00a0months (<jats:italic>P<\/jats:italic> =. 005) and language delays (<jats:italic>P<\/jats:italic> =. 048) and speech sound production disorders (SSPDs, <jats:italic>P<\/jats:italic> =. 040) at 5 years. Receiving tubes before palatoplasty was associated with failed newborn hearing screen (<jats:italic>P<\/jats:italic> =. 001) and younger age at first posttubes type B tympanogram with normal canal volume (<jats:italic>P<\/jats:italic> =. 015). Hearing loss after tubes (<jats:italic>P<\/jats:italic> =. 021), language delays (<jats:italic>P<\/jats:italic> =. 025), SSPDs (<jats:italic>P<\/jats:italic> =. 003), and velopharyngeal insufficiency (<jats:italic>P<\/jats:italic> =. 032) at 5 years and speech surgery (<jats:italic>P<\/jats:italic> =. 022) were associated with more tubes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Continued middle ear disease, reflected by hearing loss and multiple tubes, may impair speech and language development. Inserting tubes before palatoplasty did not mitigate these impairments better than later tube placement.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817703926","type":"journal-article","created":{"date-parts":[[2017,5,2]],"date-time":"2017-05-02T08:00:50Z","timestamp":1493712050000},"page":"504-514","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["The Impact of Tympanostomy Tubes on Speech and Language Development in Children with Cleft Palate"],"prefix":"10.1002","volume":"157","author":[{"given":"Amber D.","family":"Shaffer","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology Children\u2019s Hospital of Pittsburgh of UPMC Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Ford","sequence":"additional","affiliation":[{"name":"Division of Cleft Craniofacial Center Children\u2019s Hospital of Pittsburgh of UPMC Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukgi S.","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Children\u2019s Hospital of Pittsburgh of UPMC Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Children\u2019s Hospital of Pittsburgh of UPMC Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200310000-00004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107688808101209"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.63.2.176"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.44.1.35"},{"key":"e_1_2_8_6_1","first-page":"99","article-title":"Unexpected ear disease in infants with cleft palate","volume":"4","author":"Stool SE","year":"1967","journal-title":"Cleft Palate J"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1985.00800030044003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2015.11.014"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2004.03.006"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1277715"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2009.07.015"},{"issue":"1","key":"e_1_2_8_12_1","first-page":"CD001801","article-title":"Grommets (ventilation tubes) for hearing loss associated with otitis media with effusion in children","author":"Lous J","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1989.01860340071020"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-199204000-00003"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.e58"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200104193441601"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.112.2.265"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050406"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062980"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198506133122401"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2010.10.032"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815623467"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812468849"},{"key":"e_1_2_8_24_1","volume-title":"Velopharyngeal Incompetence: Audio Seminars in Speech Pathology","author":"McWilliams BJ","year":"1979"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0b013e318180a4e0"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24727"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2010.04.016"},{"key":"e_1_2_8_28_1","unstructured":"Annual Data Early Hearing Detection and Intervention (EHDI) Program(2013).http:\/\/www.cdc.gov\/ncbddd\/hearingloss\/ehdi\u2010data.html. 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