Early placement of ventilation tubes in cleft lip and palate patients: Does palatal closure affect tube occlusion and short-term outcome?

Klockars, Tuomas; Rautio, Jorma

doi:10.1016/j.ijporl.2012.06.028

Cited by 43 publications

(40 citation statements)

References 16 publications

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“…The high OME resolution rates were supported by four other studies, in which persistent OME Designing Strategies for Cleft Lip and Palate Carewas observed in less than half (29-52%) of the CLP children in the first 4-7 years after VTI [20,44,68,72]. Eustachian tube function began to normalize by 7-9 years of age [20,43,44,50,51,58,67,68,72]. In addition, fewer than half of the CLP children (17-45%) presented OME recurrence within the first 3-6 years of follow-up [20,56,57,61].…”

Section: Summary Of Evidence On Middle Ear Statusmentioning

confidence: 64%

“…However, otorrhea has not been systematically studied in CLP children after VTI. Some studies have reported a low probability (4-11.5%) of post-VTI otorrhea in CLP children [44,50,66,79], whereas others reported inconsistent results (55-68%) [31,57,78]. The evidence is inconclusive due to conflicting results among these studies.…”

Section: Otorrheamentioning

confidence: 99%

“…Thus, many doctors prefer to perform the repair of cleft palate and ventilation tube surgery simultaneously when the child is 1 year old [2,17,[48][49][50]. This combined surgical approach is done in the hope of overcoming the problem of middle ear effusion and improving the hearing ability of children, thereby enhancing their long-term…”

Section: Ventilation Tube Insertion (Vti) For Omementioning

confidence: 99%

“…The rates of OME resolution were reported in three high-quality studies, including a randomized control trial, a prospective cohort study, and a retrospective cohort study [50,51,58]. The rates of OME resolution ranged from 48.7 to 86% within the first 6.5 years.…”

Section: Comparative Effectiveness For Middle Ear Statusmentioning

confidence: 99%

“…Three high-quality studies reported that more than half (48.7-86%) of the CLP children that underwent VTI presented OME resolution within the first 6.5 years [50,51,58]. The median resolution time of conductive hearing loss was found to be approximately 5 years [23].…”

Section: Summary Of Evidence On Middle Ear Statusmentioning

confidence: 99%

See 4 more Smart Citations

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

Kuo¹,

Shiao²

2017

Designing Strategies for Cleft Lip and Palate Care

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The condition of cleft lip/palate (CLP) in children is psychologically stressful for family members and debilitating for the patients themselves. These children must undergo a series of major invasive surgeries following birth, including cleft lip repair surgery, cleft palate repair surgery, bone grafting surgery, and dental implant surgery. Unfortunately, the clinical significance of otitis media with effusion (OME), a complication associated with CLP, is often overlooked, and very few studies have explored this condition in depth. This chapter reviews pathogenesis, clinical manifestations, consequences, examination, and diagnosis related to OME in children with CLP. Controversies surrounding the treatment of OME in CLP children are also discussed. We also provide a flowchart for management guidance in OME in children with CLP.

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Section: Summary Of Evidence On Middle Ear Statusmentioning

confidence: 64%

Section: Otorrheamentioning

confidence: 99%

Section: Ventilation Tube Insertion (Vti) For Omementioning

confidence: 99%

Section: Comparative Effectiveness For Middle Ear Statusmentioning

confidence: 99%

Section: Summary Of Evidence On Middle Ear Statusmentioning

confidence: 99%

See 3 more Smart Citations

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

Kuo¹,

Shiao²

2017

Designing Strategies for Cleft Lip and Palate Care

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Timing of First Set of Pressure Equalization Tubes in Pediatric Patients With Cleft Deformities

Greenlund,

Sajjadi,

Nowariak

et al. 2024

The Laryngoscope

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ObjectivesChildren with cleft palates often have comorbid eustachian tube dysfunction requiring pressure equalization tubes (PETs). PETs can relieve middle ear effusions that impede hearing. Ideal PET placement timing in this population is controversial. In this study, the audiologic exam passing rates of patients with cleft palate prior to and following PET insertion were assessed. Rates for patients receiving PETs at different ages were compared. It was hypothesized that earlier PET placement may benefit patients with additional months of improved hearing.MethodsA retrospective chart review was performed of patients with cleft palate between November 22, 2016 and November 22, 2021 at a tertiary center. Statistical analysis compared passing/normal audiologic exams in patients receiving PETs at different ages.ResultsA total of 348 patients had cleft palate diagnoses, received PETs, and had adequate hearing data for inclusion. Those with PETs inserted at 3 months of age or less had an increase in percent of patients passing audiologic exams following versus prior to PET insertion of 13% (1.3 times improvement). Those receiving PETs between 7‐ and 12‐months had the largest rate of improvement (42%) (2.4 times improvement); other groups had changes in passing rates between 31% and 40%. The rate of passing audiologic exams following PET insertion was high across all groups, ranging from 66% to 81%.ConclusionThis is one of the first studies exploring the timing of PET placement in this population and showed that patients receiving PETs at 3 months of age or younger passed subsequent audiologic exams at similar rates relative to those receiving PETs later in life.Level of Evidence3 Laryngoscope, 2024

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Relationship between cleft palate width and otitis media

Yoshitomi

Baba

Tamada

et al. 2022

Laryngoscope Investig Oto

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Objectives: To investigate the relationship between cleft width and otitis media (OM) and to determine whether a wide cleft palate (CP) is a risk factor of the incidence, type, amount of middle ear effusion, and prolonged morbidity in OM.Study Design: Retrospective cohort study.Methods: Children with CP who underwent palatoplasty between 2014 and 2018 were analyzed. Cleft width was measured at palatoplasty. The incidence of otitis media with effusion (OME) and acute otitis media (AOM), the type and amount of middle ear effusion, and OME duration and age at resolution were assessed in relation to cleft width.Results: One hundred eighteen children were included. The CP types were Veau I in 16, II in 35, III in 48, and IV in 19 patients. The incidence of OME and AOM before palatoplasty was 83.1% and 49.2%, respectively. Cleft width did not differ significantly between patients with or without OME but was significantly greater in those with, than in those without, AOM (p < .001), in those with mucoid, than in those with serous, effusion (p = .012), and in those with complete, than in those with partial, effusion (p = .01). Regardless of cleft width or type, OME persisted for a median duration of 50 months.Conclusions: Cleft width was significantly associated with the incidence of AOM and the type and amount of middle ear effusion before palatoplasty. However, it was not significantly related to the incidence, age at resolution, or duration of OME. Regardless of cleft width or type, OM in children with CP requires long-term follow-up.

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Early placement of ventilation tubes in cleft lip and palate patients: Does palatal closure affect tube occlusion and short-term outcome?

Cited by 43 publications

References 16 publications

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

Timing of First Set of Pressure Equalization Tubes in Pediatric Patients With Cleft Deformities

Relationship between cleft palate width and otitis media

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