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Treatment and Outcome of Otitis Media With Effusion in Cleft Palate Patients

Presenting Author: Yingmin Hoe

Published online by Cambridge University Press:  03 June 2016

Yingmin Hoe
Yingmin Hoe*
Affiliation:
KK Women's and Children's Hospital
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Abstract

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Learning Objectives: This study aims to investigate the impact of OME in children with cleft palate.

Objective: Otitis media with effusion (OME) is common in children with cleft palate due to Eustachian tube dysfunction. This study aims to investigate the impact of OME in children with cleft palate.

Study Design: Retrospective case series.

Methods: The case records of patients with cleft palate were analyzed for: type of cleft, age at which repair of cleft palate was performed, age of presentation to the otolaryngologist, age at which Myringotomy and Tympanostomy (M&T) was done, total number of M&Ts performed and associated congenital syndromes.

Results: M&Ts- Out of 600 cleft palate and lip patients, 204 required M&T. 26.5% required ≥3 M&T and 12.3% required ≥4 M&T. 86.8% of the patients presented early.

Syndromic patients- 15.7% were syndromic with Pierre Robin being the most common syndrome. They did not require more surgery (p=0.713) nor presented to an Otolaryngologist earlier (p=0.281) than their non-syndromic counterparts.

Type of cleft- 22.1% had unilateral cleft lip and palate, 32.8% had bilateral cleft lip and palate, 40.7% had posterior cleft palate and 4.4% had submucous cleft palate. Patients with bilateral cleft lip and palate required more M&Ts than those with posterior and submucous clefts (p=0.16).

Conclusion: OME in cleft palate patients should be actively identified and addressed early, before the development of significant disability. A proportion of patients will have recurrent OME and caregivers should be aware of the need for multiple procedures and long term follow up. Opportunities for combined surgery should be pursued.