Background/Aim. Otitis media with effusion (OME) is almost universal in children with cleft palate with an incidence of more than 90%, but the approach to managing this problem varies significantly among authors. The Eustachian tube dysfunction is the main factor that leads to the presence of the middle ear effusion. This is especially prominent in children with congenital cleft palate and explains the prolonged course of this process. The objective of this study was to determine the effectiveness of early ventilation tubes insertion in children with cleft palate at the time of palatoplasty by monitoring the course and duration of the disease as well as development of complications. Methods. In the prospective study with predefined regular follow-up intervals and parameters, the two groups of children were observed. The group one (E) included 45 children with congenital cleft palate who underwent the early insertion of ventilation tubes during palatoplasty, and the group two (C) had the same number of children with cleft palate who were treated conservatively on an as-needed basis. Assessment parameters were findings of otomicroscopy, tympanometry, play and pure tone audiometry. Each child was followed-up for 5 full years at total of nine follow-up examinations. Results. Result analysis showed that there were no statistically important differences between the two study groups in terms of the course and duration of the presence of the middle ear effusion, or in terms of complications and speech development. Conclusion. Based on the results obtained, we can conclude that there is no significant benefit in early ventilation tubes insertion in children with cleft palate, therefore our recommendation is watchful waiting and a conservative treatment on an as-needed basis, with the ventilation tubes insertion when a surgeon, based on his or her experience and individual findings considers it necessary.

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The aim of this study was to indicate the importance of surgical treatment of nasal septal deviation in children as early correction of functional and cosmetic nose deformities. In this study, we presented 76 children, from age of 7 to 15, who were surgical treated for the reason of nasal septal deviation starting from January 2001. to December 2009. There were 48 (63%) male and 28 (37%) female patients. The lowest number of patients were between 7 and 9 years old--5 (6.5%), between 10 and 12 years--28 (37%) and 43--(56.5%) between 13 and 15 years. Only 7 (9%) patients indicated genetics inheritance, and 11 of them (14%) could not determine the exact cause of deviation origin. References taken from the parents showed that nasal septal deviation developed like consequence of injury in 58 (76%) cases. We used closed technique of septoplasty with hemitransfictional incision and sub mucosal resection. Deviated portion of septum was completely removed. Patients felt improvement in nose breathing in 65 (85%) cases. The most often complication was nasal obstruction in 6 (8%) cases which occurred due to the insufficient removal of deviated portion. We also had a septal perforation in one and abscess of nasal septum in another case. There were no esthetic deformities.Surgical treatment of nasal septal deviation in children must to be conservative and limited on injured part of septum. After the operation nose breathing significantly improved, without consequences on esthetic appearance or the growth of central part of a face.

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Myringoplasty is a reasonably successful method with good functional results in pediatric patients. Risk factors of surgical failure are young age, the size of auricular tragus perforation and pathological conditions of the contra lateral ear. The tragal cartilage gives better results in cases with bilateral perforations because the possibility of retractions and re-perforations is lower. Relatively small number of patients is probably the reason that, exept for young age, differences between the two groups did not reach the level of statistical significance.