Balancing intervention and complications: management of otitis media with effusion in children with cleft palate

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Burçay Tellioğlu1, Erim Pamuk1, Muhammed Çağrı Külekci1

  • 1Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, Ankara, Türkiye.

The Turkish Journal of Pediatrics
|July 17, 2025
PubMed

Insights

Preoperative hearing loss severity predicts the need for ventilation tubes (VT) in children with cleft palate (CP). Mild to moderate hearing loss increases the likelihood of VT insertion, guiding individualized treatment decisions.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Audiology

Background:

  • Children with cleft palate (CP) face high risks of otitis media with effusion (OME), potentially impacting hearing, speech, and development.
  • Ventilation tube (VT) insertion during palatoplasty is common but its routine use is debated due to uncertain benefits and risks.

Purpose of the Study:

  • Identify preoperative audiological predictors for VT necessity in CP patients.
  • Evaluate VT-related complications in this population.

Main Methods:

  • Retrospective review of 65 non-syndromic CP patients undergoing palatal repair without prior VT.
  • Analysis of preoperative hearing thresholds, cleft severity (Veau classification), and postoperative VT insertion/complications.

Main Results:

  • VT insertion likelihood significantly increased with preoperative hearing loss severity (5.9% normal hearing to 75% moderate CHL).
  • Mild to moderate conductive hearing loss (CHL) showed significant differences compared to normal hearing (p < 0.001).
  • Higher cleft severity correlated with increased VT placement (Veau I: 10%, Veau IV: 69.2%), but not with preoperative hearing or complications.

Conclusions:

  • Preoperative hearing level is a strong predictor of VT need in CP patients.
  • Mild to moderate CHL warrants early intervention, while normal hearing may benefit from a conservative approach.
  • Individualized, hearing-based decisions for VT placement are recommended over routine use.
Abstract

Keywords:
audiologycleft palateconductive hearing lossotitis media with effusionventilation tube

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