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Conservative management of otitis media in cleft palate

Richard Shaw1, David Richardson, Siobhan McMahon

  • 1Maxillofacial Unit, University Hospital Aintree, Liverpool, UK. richardjohnshaw@hotmail.com

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|October 18, 2003
PubMed

Insights

A conservative approach to managing otitis media with effusion in children with cleft palate resulted in grommet insertion for 29% of patients. Those receiving grommets showed improved speech outcomes, particularly in more severe clefting cases.

Area of Science:

  • Pediatric Otolaryngology
  • Craniofacial Surgery
  • Speech Pathology

Background:

  • Eustachian tube dysfunction is prevalent in children with cleft palate, necessitating varied management strategies.
  • Current practices range from routine prophylactic grommet insertion to conservative approaches for otitis media with effusion.
  • This study evaluates outcomes from a conservative management strategy in a cleft care setting.

Purpose of the Study:

  • To present outcome data for children with cleft palate managed conservatively for otitis media with effusion.
  • To analyze the rate of grommet insertion and its correlation with cleft severity and patient outcomes.
  • To compare otological and speech results between children who received grommets and those who did not.

Main Methods:

  • Retrospective analysis of consecutive palate repairs over a 10-year period.
  • Inclusion of patients with available data, excluding those with sensorineural deafness or syndromic clefting.
  • Assessment of cleft severity (LAHSHAL), otological status, and speech outcomes.

Main Results:

  • Data analyzed for 72 out of 109 patients; 29% required grommets under the conservative approach.
  • Grommet insertion was more frequent in patients with more severe clefting.
  • Patients receiving grommets demonstrated better speech results, though not statistically significant.

Conclusions:

  • A conservative management strategy for otitis media with effusion in cleft palate patients does not lead to poor otological outcomes.
  • Grommet insertion in this cohort was associated with improved speech results, particularly in cases of more severe clefting.
Abstract

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