Surgical Therapies for Cleft Palate Patients with Otitis Media with Effusion

This research tried to compare the hearing improvement of different surgical therapies of cleft palate (CP) patients with otitis media with effusion (OME).

We selected 234 ears of 117 CP patients with OME, who were planning to undergo palatoplasty in the Department of Oral and Maxillofacial Plastic and Trauma Surgery, Beijing Stomatological Hospital, Capital Medical University, to analyze them in the study. The patients, whose ages ranged from 6 months to 6 years, were categorized into 2 groups depending on the procedure to be performed: palatoplasty alone and palatoplasty with insertion of ventilation tubes (VTI). Each patient had acoustic impedance tests and auditory brainstem response (ABR) tests during the preoperative stage, at 6 months and 12 months after the surgery. A number of relevant parameters, such as preoperative/postoperative hearing test outcomes, were taken and evaluated.

The same team of maxillofacial surgeons and otolaryngologists successfully completed all Procedures. By March 2026, 100% of patients had completed 6-month postoperative follow-up, and 37 patients who had palatoplasty alone and 53 patients who had palatoplasty with VTI had completed 12-month postoperative follow-up. There was no apparent variation in the preoperative hearing loss between the 2 groups of patients (P>0.05). The postoperative average value of ABR V-wave threshold at 6 months and 12 months was lower than that before operation in the 2 groups (P<0.05). In addition to that, the average value of hearing threshold in patients with normal hearing at 6 months and 12 months after surgery was greater in the group of palatoplasty alone compared with the group of palatoplasty with VTI (P<0.05). A statistically significant difference in the proportion of ears having normal hearing between the 2 groups at 6 months and 12 months after operation was found (P<0.05). Eight children who underwent palatoplasty with VTI completed audiological tests 2 years later, and the hearing results were found to be normal.

CP patients with OME can undergo palatoplasty with or without VTI to enhance hearing. Postoperative hearing of CP children with OME who underwent palatoplasty and VTI showed a marked improvement, whereas it showed a minimal improvement when palatoplasty was performed. Within the limitations of this retrospective study, palatoplasty with VTI demonstrated superior hearing outcomes compared with palatoplasty alone in children with CP and OME. The findings provide additional evidence from a Chinese pediatric cohort and suggest that the benefits of combined treatment may extend through the key period of speech and language development. Further prospective studies with larger long-term follow-up cohorts are still needed.