Long-term results and surgical indication of ventilating tube insertion during cleft palate surgery

s: While ventilating tube insertion (VTI) is often performed, its necessity in cleft palate (CP) children without otitis media with effusin (OME) remains unclear.

We aim to reassess the safety of refraining from early VTI in CP children who do not have evidence of OME.

We retrospectively reviewed 1026 children with CP who underwent surgery at the Asan Medical Center (Jan 2000-Dec 2015). Among these, 69 patients (34 males, 35 females) had no history of otitis media and no middle ear effusion during preoperative endoscopic examination; they did not receive VTI. Factors such as age, gender, CP type, follow-up duration, and OME prevalence were analyzed.

Of the 69 enrolled patients, the incomplete CP type was the most common (43.5 %). Only 5 (7.2 %) developed OME postoperatively, with the complete CP type being most frequent (60 %). One patient required VTI, while the remaining cases showed spontaneous resolution within six months.

Watchful waiting appears to be a safe approach for children with CP who do not exhibit preoperative OME. Despite a 7.2 % incidence of late-onset OME, male patients with complete CP may require closer monitoring.