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Int J Pediatr Otorhinolaryngol. 2012 May;76(5):718-21. doi: 10.1016/j.ijporl.2012.02.027. Epub 2012 Mar 3.

Clinical outcomes of ventilation tube placement in children with cleft palate.

Author information

1
Department of Otorhinolaryngology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan. hitomek@med.showa-u.ac.jp

Abstract

OBJECTIVE:

The purpose of this study was to investigate the long-term clinical outcomes in children with cleft palate.

METHODS:

One hundred eight patients with cleft palate (CP) were investigated. Microscopic observation of the middle ears was performed periodically. If chronic otitis media with effusion (OME) was diagnosed at 1 year of age or later, ventilation tube (VT) placement was performed. The air-filled area of the mastoid air cells was checked on X-rays obtained at 1 and 5 years. The data from each measurement were tested statistically by the bootstrap method and Wilcoxon's rank-sum test. The clinical course from age 6 to the final examination (average 9.42 years) and the language development at 5 years were analyzed using data from the medical records of individual patients.

RESULTS:

VT placements were performed at 5 years of age or younger in 41 CP patients (82 ears, 38%). About 30% of patients treated by VT placement at 5 years of age or younger required myringotomy and/or VT re-placement at 6 years of age or over. Ninety-five percent of patients who had not been treated by VT insertion at 5 years of age or younger showed a favorable subsequent clinical course. Patients treated by VT insertion at 5 years of age or younger had significantly smaller mastoid air cell areas as measured at 5 years of age and also at 1 year of age. No significant difference in language development was observed between the CP patients that underwent /did not undergo VT placement.

CONCLUSIONS:

VT placement should be positively undertaken in CP children who have small mastoid air cell areas as measured at 1 year of age, because an unfavorable prognosis of OME is expected in such patients. It is considered that patients treated by VT placement at 5 years of age or younger should be carefully followed up for the development of OME even after 6 years of age. Thus, measurement of the mastoid air cell area at the age of 1 year is useful for determining the therapeutic program.

PMID:
22386274
DOI:
10.1016/j.ijporl.2012.02.027
[Indexed for MEDLINE]

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