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J Craniomaxillofac Surg. 2015 Dec;43(10):2112-5. doi: 10.1016/j.jcms.2015.09.008. Epub 2015 Oct 9.

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

Author information

1
Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: drkuscu@gmail.com.
2
Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: rogunaydin@gmail.com.
3
Hacettepe University, Department of Otorhinolaryngology, Audiology and Speech Pathology Unit, Ankara, Turkey. Electronic address: mehtap_ozturk06@hotmail.com.
4
Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: ergunooc@yahoo.com.
5
Hacettepe University, Department of Otorhinolaryngology, Audiology and Speech Pathology Unit, Ankara, Turkey. Electronic address: mavis@hacettepe.edu.tr.
6
Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: tyilmaz@hacettepe.edu.tr.
7
Department of Plastic and Reconstructive Surgery, Hacettepe University Medical School, Ankara, Turkey. Electronic address: fozgur@hacettepe.edu.tr.
8
Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: umutakyol@yahoo.com.

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.

KEYWORDS:

Cleft palate; Effusion; Grommet tube; Otitis media

PMID:
26545930
DOI:
10.1016/j.jcms.2015.09.008
[Indexed for MEDLINE]

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