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Evaluation of Ventilation Tube Placement and Long-term Audiologic Outcome in Children With Cleft Palate
Insights
Multiple ventilation tube (VT) placements in children with cleft palate may not improve long-term hearing. More tubes correlated with worse hearing outcomes at age 10, indicating a need for revised treatment guidelines.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Genetics
Background:
- Cleft palate is associated with middle ear disease and hearing loss.
- Ventilation tubes (VT) are commonly used to manage otitis media in these children.
- Long-term hearing outcomes after VT placement require further investigation.
Purpose of the Study:
- To assess the impact of ventilation tube (VT) placement on long-term hearing in children with cleft palate.
- To identify factors influencing hearing acuity at age 10 in this population.
Main Methods:
- Retrospective case series with chart review.
- Analysis of data from a genetic and dysmorphology database.
- Inclusion of children diagnosed with cleft palate who underwent surgery between 1995 and 2002.
Main Results:
- An increased number of ventilation tubes (VT) was associated with a higher incidence of hearing loss at age 10.
- Adjusting for otologic complications did not alter this association.
- The timing of initial VT placement did not significantly affect long-term hearing outcomes.
Conclusions:
- Multiple VT placements may not enhance long-term hearing outcomes in children with cleft palate.
- Further research is needed to develop patient-centered criteria for VT decision-making.
- Current findings suggest a re-evaluation of treatment protocols for otitis media in this cohort.
Objective:
The purpose of this study was to assess the effect of ventilation tube (VT) placement on long-term hearing outcomes in children with cleft palate.
Study Design:
Case series with chart review.
Setting:
Genetic and dysmorphology database at Rady Children's Hospital-San Diego (RCHSD).
Patients:
Children with cleft palate diagnosis who underwent surgery at RCHSD between 1995 and 2002.
Main Outcome Measure:
The primary outcome studied was hearing acuity at 10 years of age. Independent variables studied included gender, age at palate repair and first VT placement, total number of VTs, number of complications, and presence of tympanic membrane perforation.
Results:
An increased number of tubes was associated with a greater incidence of hearing loss at age 10, even after adjusting for total number of otologic complications. The timing of initial tube placement did not have a significant effect on long-term hearing outcome in this study.
Conclusions:
While children with worse middle ear disease are more likely to receive more tubes and have long-term conductive hearing loss as a result of ear disease, the results of this study suggest that multiple tube placements may not contribute to improved long-term hearing outcomes. Further research focusing on long-term outcomes is needed to establish patient-centered criteria guiding decision making for ventilation tube placement in children with cleft palate.
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