The effect of early routine grommet insertion on management of otitis media with effusion in children with cleft palate

• Published in: Journal of cranio-maxillo-facial surgery Vol. 43; no. 10; pp. 2112 - 2115
• Main Authors: Kuşcu, Oğuz, Günaydın, Rıza Önder, İcen, Mehtap, Ergün, Onur, Kulak Kayikci, Mavis Emel, Yılmaz, Taner, Özgür, Fatma Figen, Akyol, Mehmet Umut
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.12.2015
• Subjects: Child; Cleft palate; Cleft Palate - complications; Dentistry; Effusion; Grommet tube; Humans; Middle Ear Ventilation - methods; Otitis media; Otitis Media with Effusion - surgery; Surgery; Otitis media; Grommet tube; Cleft palate; Effusion
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2015.09.008

Abstract Purpose The aim of the study is to compare long term otoscopic and audiological findings of cleft palate patients with or without early grommet insertion. Methods Cleft palate patients followed-up in Hacettepe University between 2008 and 2013 were included in the study. Age, gender, cleft types and palate surgery data, grommet tube insertion history and otological – audiological evaluations of the patients were recorded. Patients were evaluated in three groups according to grommet insertion history: A-early routine grommet insertion, B-grommet insertion during follow-up, C-no grommet insertion. Otological and audiological findings were compared. Results There were 154 patients in the study, with a median age of 7.7 years. There were 67 patients in group A (43.5%), 22 patients in group B (14.3%) and 65 patients in group C (42.2%). OME was identified significantly higher in group A and normal otoscopic examination findings were higher in group C. Complications showed a higher rate than other otoscopic findings in group B patients. There was no significant difference for any frequencies in between the groups in terms of mean air-bone gap (ABG) values. There were 20 grade I, 25 grade II, 77 grade III and 32 grade IV patients in the study according to the Veau classification. Conclusion Prophylactic grommet insertion may not be applied as some cleft palate patients with no OME. Wait and see protocol can be recommended for these patients, and they should be followed-up up closely to avoid complications. If the effusion does not recover or tympanic membrane changes occur in follow-up, grommet insertion should be considered.