Effectiveness of ventilation tube insertion for conductive hearing loss in children with chronic otitis media with effusion and non-syndromic cleft palate: a systematic review protocol

Abstract

This review will investigate the efficacy of ventilation tube insertion versus non-surgical options in the management of chronic otitis media with effusion in children with non-syndromic cleft palate by assessing the degree of conductive hearing loss.Introduction: Chronic otitis media with effusion is common in children with cleft palate due to associated eustachian tube dysfunction. It can lead to impaired hearing and can hinder speech and language development. The main treatment options are drainage of effusion with ventilation tubes, surveillance, or amplification with hearing aids. Each of these approaches has its advantages but there is currently no consensus on the most appropriate management in children with cleft palate.Inclusion criteria: Eligible studies will include children (<18 years) with cleft palate not associated with a genetic syndrome, diagnosed with chronic otitis media with effusion, who have undergone insertion of ventilation tubes compared with either surveillance or amplification with hearing aids.Methods: A comprehensive search of MEDLINE, CINAHL, Embase, and Scopus will be conducted to find published literature. Gray literature searches will be conducted through the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and ProQuest Dissertations and Theses Global. Two reviewers will screen studies, conduct critical appraisal of eligible studies, assess the methodological quality, and extract the data. Where possible, studies will be pooled in statistical meta-analysis, with heterogeneity of data being assessed using the standard x 2 and I 2 tests. Systematic review registration number: PROSPERO CRD42021255861

Managing Chronic otitis media with Effusion in Children with non-Syndromic Cleft Palate: Short-Term Ventilation Tubes Versus Surveillance

“…This systematic review was conducted in accordance with the JBI (formerly Joanna Briggs Institute) methodology for systematic reviews of effectiveness. 22 An a priori protocol 23 was developed and registered in PROSPERO (CRD42021255861). The protocol developed also sought to consider hearing aids but unfortunately the studies found considered both syndromic and non-syndromic participants with no distinction made in data analysis and thus this intervention was not included in the final review.…”

“…The remaining 236 articles were subjected to full text screening which resulted in exclusion of 232 articles based on requirements established in the protocol. 23 The final four articles were eligible for data extraction. [29][30][31][32][33][34]…”

Poor reporting quality of observational studies in children with non-syndromic cleft palate makes evidence synthesis difficult

“…The review was conducted in accordance to JBI methodology for systematic reviews of effectiveness 9 and the protocol was registered with PROSPERO (CRD42021255861). 5 The outcomes of interest in the review were hearing thresholds, speech and language development and otological complications and these were informed by a study that integrated the views of clinical and non-clinical stakeholders in developing core outcomes sets for children with otitis media with effusion and cleft palate. 10…”

“…It is important that this condition is managed in a timely manner to ensure that the developmental milestones of these children are at par with their peers, as well as mitigating the associated costs to the public health system. 5 A recent systematic review conducted to determine the best management for chronic otitis media with effusion in children with non-syndromic cleft palate could not derive concrete conclusions regarding the most effective management. The review highlights the difficulties in evidence synthesis that are brought about by inconsistent and incomplete reporting of outcomes in observational studies, especially when reporting guidelines are not utilised.…”

“…It is important that this condition is managed in a timely manner to ensure that the developmental milestones of these children are at par with their peers, as well as mitigating the associated costs to the public health system. 5…”