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Subannular Tubes in Children With Cleft Palate

Sónia Pires Martins1,2, Pedro Lopes Alexandre1,2, Margarida Santos1

  • 1Department of Otorhinolaryngology, Centro Hospitalar Universitário São João, Oporto, Portugal.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|February 4, 2021
PubMed

Insights

Subannular tube (SAT) placement effectively treats chronic middle ear disease in children with cleft palate, improving hearing and ear aeration long-term. This safe alternative requires careful postoperative monitoring for optimal outcomes.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Medical Devices

Background:

  • Chronic middle ear disease is common in children with cleft palate.
  • Intractable otitis media with effusion and tympanic membrane retraction pose treatment challenges.

Purpose of the Study:

  • To investigate subannular tube (SAT) placement as an alternative treatment for chronic middle ear disease in children with cleft palate.
  • To evaluate audiological outcomes, tube duration, and complications associated with SAT insertion.

Main Methods:

  • Retrospective cohort study involving 21 children with cleft palate (aged 3-14 years).
  • Evaluation of 38 ears treated with transtympanic tubes followed by SAT insertion.
  • Analysis of audiological outcomes, average tube duration, and postoperative complications over a median follow-up of 42 months.

Main Results:

  • SATs remained in situ in 76.3% of cases, with 68.4% of tympanic membranes showing no significant alterations.
  • Mean SAT duration was 16 months, significantly longer than transtympanic tubes.
  • Significant sustained hearing improvement was observed, with a low complication rate (69.2% no complications).

Conclusions:

  • Subannular tube insertion offers a safe and effective long-term solution for middle ear aeration in children with cleft palate.
  • SATs lead to hearing improvement and reversion of tympanic retraction pockets.
  • Close postoperative follow-up is essential for successful treatment outcomes.
Abstract

Keywords:
hearing losspediatricssurgical technique

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