Serous otitis media as a cause for language delay following cleft palate repair-A case-control study

Serous otitis media (SOM), also called otitis media with effusion (OME) or glue ear, is a collection of non-purulent fluid within the middle ear space. Children with cleft palate are more prone to develop this condition. This is caused by impaired eustachian tube function in cleft palate. They may present with hearing loss, delayed speech, and language development or poor social behavior. This is a significant cause of conductive hearing loss in the early speech-forming years of their life. Even after an early surgical repair of palate, speech and language defects are frequently identified during regular postoperative follow-up by speech-language pathologists. When identified, the approach to language delay varies across healthcare systems and includes watchful waiting, providing hearing aids to early otological intervention. The primary objective was to compare the incidence of SOM in children with and without language delay following surgical correction of cleft palate.

A case-control study involving 63 patients was conducted in a tertiary care hospital with a high-volume cleft lip and palate center from June 2022 to March 2023. Thirty children with language delay were identified and grouped as cases and 33 children without language delay as controls. Tympanogram was conducted after the detailed otoscopic examination. Those with Jerger types B and C were diagnosed with SOM. The incidence of SOM in each group was compared statistically.

About 70% of cases and 87.9% of controls had SOM. There is no positive correlation between the incidence of SOM and language delay (P-value > 0.05).

SOM cannot be identified as a causal factor for language delay after cleft palate surgery.