Hearing and Otologic Outcomes After Routine Versus Selective Ventilation Tube Insertions in Children With Cleft...

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Audiology

Background:

• Children with cleft palate often experience middle ear issues, necessitating interventions like ventilation tube insertion (VTI).
• The decision to perform VTI during palatoplasty has shifted from routine to selective approaches.
• Evaluating the impact of these different VTI protocols on audiology and otology outcomes is crucial.

Purpose of the Study:

• To compare audiologic and otologic outcomes between routine and selective ventilation tube insertion (VTI) during palatoplasty in children with cleft palate.
• To assess the necessity and efficacy of selective VTI based on pre-operative evaluations.
• To determine if ENT clinical examination alone is sufficient for VTI indication.

Main Methods:

• Retrospective cohort study of children with cleft palate (CP±L) undergoing palatoplasty.
• Comparison of outcomes between a routine VTI group (pre-2019) and a selective VTI group (post-2019).
• Data collection included audiologic and ENT assessments, otorrhea, re-tympanostomy rates, and surgical complications over a 2-year follow-up.

Main Results:

• No significant differences were found in re-tympanostomy rates, hearing outcomes, or surgical complications between the routine and selective VTI groups.
• In the selective VTI group, most initially non-indicated children eventually required VTI during follow-up.
• The study included 41 children: 21 in the routine group and 20 in the selective group.

Conclusions:

• Routine ventilation tube insertion (VTI) appears necessary for children with cleft palate (CP±L).
• Ear, nose, and throat (ENT) clinical examination alone may be adequate for guiding VTI decisions.
• Selective VTI guided by ENT evaluation can reduce unnecessary audiologic assessments without compromising care quality.