The Vall d'Hebron Otolaryngology Service together with thehttp://en.vhir.org/web_vhir/portal1/grup-equip.asp?s=recerca&contentid=186741 Biomedical Research in Cancer Stem Cells of the Vall d'Hebron Research Institute (VHIR) have carried out a study in which they have verified that the degree of malformation of the palate cleft is not related to speech impairment, hearing loss or chronic otitis media. On the other hand, these otologic or audiometric alterations would be related to the number of surgeries for the insertion of ventilation and drainage tubes in the ear. Therefore, they opt for a multidisciplinary and conservative approach to this pathology.The cleft palate, occurs during pregnancy, when the palate does not develop correctly leaving an area without completely closing (cleft) that can reach the nasal cavity. The cleft palate may be isolated or together with other congenital anomalies of the head, such as the cleft lip. In fact, the cleft palate and cleft lip are the most frequent congenital malformations of the head and neck and occupy the second position among all congenital malformations."The insertion of ventilation tubes has been the standard in the treatment of children with cleft palate, as well as early surgery for closure of the palate, but the results of this study may imply a change in the approach of these patients", explains Dr. Cristina García-Vaquero, specialist of the Otolaryngology Service of Vall d'Hebron and first author of the study.The study, published in the https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-018-1312-7 journal BMC Pediatrics, was conducted in a sample of 121 patients aged between 6 and 31 years (mean age 13 years) who had undergone a cleft palate repair operation in Vall d'Hebron University Hospital between 2000 and 2014.During the study, otological, audiometric, tympanometric and speech evaluations were made to all participants. In them, no statistically significant associations were identified between the type of cleft palate and the number of surgeries that patients had undergone for the insertion of ventilation tubes.The researchers also did not see an association between the degree of cleft palate and the degree of hearing loss, of maximum impedance (resistance of the auditory system to the passage of sound) and the presence of abnormalities in the tympanic membrane that indicate chronic otitis media."However, in the subjects examined there were two clear associations. One of them is between the degree of cleft palate and hypernasality (abnormal resonance of the voice when air escapes through the nose). In the other case, they observed a relationship between chronic otitis media and hearing loss with the number of inserted ventilation tubes, "says Dr. Cristina García-Vaquero.However, although the placement of tympanic ventilation tubes is accompanied by an increase in the rate of chronic otitis media, it is necessary to continue studying whether this relationship is due to the number of tubes inserted or is intrinsic to the inflammatory disease of the middle ear that normally affects these patients.On the other hand, "the study did not reveal improvements in speech, hearing or in the long-term tympanic membrane abnormalities in those patients who underwent a more invasive approach with tympanostomy tubes, so the researchers are betting on a conservative approach ", concludes Dr. Marc Pellicer, specialist in Pediatric Otolaryngology within the Otolaryngology Service of Vall d'Hebron.The Otolaryngology, or Ear, Nose and Throat Department of Vall d'HebronThe Vall d'Hebron Otolaryngology Service has professionals who participate in multidisciplinary treatment teams, both adults and children, establishing links with various specialties, such as neurosurgery, thoracic surgery, maxillofacial surgery, plastic surgery, pediatric surgery, oncology, radiology, anesthesiology, nutrition, dermatology, internal medicine, nursing, speech therapy and researchers, among others, to improve the diagnosis and treatment of the patient."Each year, more than 31,000 patients are treated and more than 1,250 surgeries are performed between adults and children," says Dr. Juan Lorente, head of the Otolaryngology Service of Vall d'Hebron.