Clinical outcomes of ventilation tube placement in children with cleft palate

Kobayashi, Hitome; Sakuma, Tomoko; Yamada, Naohiro; Suzaki, Harumi

doi:10.1016/j.ijporl.2012.02.027

Cited by 30 publications

(48 citation statements)

References 9 publications

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“…The multiple grommet insertion rate of 23% was also almost twice as high as the background rate. Only a few previous cleft studies have included children with CL when examining grommet insertion rates (Sheahan et al, 2003;Kwan et al, 2011;Kobayashi et al, 2012). In these studies the number of children with CL ranged from seven to 62.…”

Section: Key Findingsmentioning

confidence: 99%

Grommet Surgery in Children with Orofacial Clefts in England

Fitzsimons

Copley

Meulen

et al. 2017

The Cleft Palate Craniofacial Journal

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Intervention: Children receiving grommets before the age of five. Outcome measures:The proportion of children receiving grommets before the age of five, the timing of the first grommet insertion and the proportion of children having repeat grommet insertions were examined according to cleft type, the absence or presence of additional anomalies, socio-economic deprivation, and region of residence.Results: 8,269 children were included. Before the age of five, 3,015 (36.5%) children received grommets. Of these, 33.2% received their first grommets at primary cleft repair and 33.3% underwent multiple grommet insertion procedures. The most common age for the first procedure was between six and 12 months. Children with a cleft affecting the palate were more likely to receive grommets than children with a cleft lip alone (45.5% vs. 4.5%).Grommet insertion practice also varied according to year of birth, absence or presence of additional anomalies, socio-economic deprivation, and region of residence. Conclusion:Grommets practice in children with a cleft appears to vary according to their clinical characteristics. The differences in practice observed according to deprivation and region of residence need to be further explored.

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Section: Key Findingsmentioning

confidence: 99%

Grommet Surgery in Children with Orofacial Clefts in England

Fitzsimons

Copley

Meulen

et al. 2017

The Cleft Palate Craniofacial Journal

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“…34,35 In the high-quality prospective cohort study by Hubbard et al, 29 children who had undergone early VTI demonstrated significantly better consonant articulation and were less likely to need speech therapy than those who had not received this treatment. The 2 retrospective studies also showed that VTI is beneficial for speech and language outcomes in children with cleft palate and OME; however, outcome differences between the VTI and non-VTI groups failed to reach significance.…”

Section: Comparative Effectiveness Of Vti For Hearing Outcomementioning

confidence: 99%

Grommets for Otitis Media With Effusion in Children With Cleft Palate: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVE: No consensus has yet been reached with regard to the link between otitis media with effusion (OME), hearing loss, and language development in children with cleft palate. The objective of this study was to address the effectiveness of ventilation tube insertion (VTI) for OME in children with cleft palate. METHODS:A dual review process was used to assess eligible studies drawn from PubMed, Medline via Ovid, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, and reference lists between 1948 and November 2013. Potentially relevant papers were selected according to the full text of the articles. Relevant data were extracted onto a data extraction sheet. RESULTS:Nine high-or moderate-quality cohort studies were included in this study. VTI was administered in 38% to 53% of the OME cases, and more severe cases appeared more likely to undergo VTI. Compared with conservative forms of management (eg, watchful waiting), VTI has been shown to be beneficial to the recovery of hearing in children with cleft palate and OME. A growing body of evidence demonstrates the benefits of VTI in the development of speech and language in children with cleft palate and OME. These children face a higher risk of complications than those undergoing conservative treatments, the most common of which are eardrum retraction and tympanosclerosis, with an incidence of ∼11% to 37%. CONCLUSIONS:This review provides evidence-based information related to the selection of treatment for OME in children with cleft palate. Additional randomized controlled trials are required to obtain bias-resistant evidence capable of reliably guiding treatment decisions. The conclusions in this review are based on underpowered cohort studies and very-low-strength evidence. Dr Kuo contributed to the conception and design of this research and the acquisition, analysis, and interpretation of data, drafted the first version of the manuscript, and participated in a critical revision of the manuscript; Dr Tsao contributed to the conception and design of the research and the acquisition, analysis, and interpretation of data and participated in revising the manuscript; Dr Cheng participated in the conception and design of the research and the analysis and interpretation of data and approved revisions to the manuscript; Drs Lien, Hsu, and Huang participated in the conception and design of the research, analysis and interpretation of data, and revision of the manuscript; Dr Shiao contributed to the conception and design of the research, acquisition, analysis, and interpretation of data and participated in critical revisions of the manuscript; and all authors approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…No differences in speech or language development were observed between CLP children that underwent conservative observation and those that underwent aggressive VTI, over the short term (0-5 years) [44,72] or long term (8-10 years) [70,71]. Further, assessments of speech by Merrick et al revealed a similar percentage of children with normal or near-normal speech intelligibility ratings in the CLP and non-CLP groups [69].…”

Section: Summary Of Evidence On Speech and Language Outcomesmentioning

confidence: 91%

“…Several studies have assessed speech and language outcomes in CLP patients with OME, including prospective [60] and retrospective cohort studies [44,[69][70][71][72]. Five articles compared children that were or were not administered VTI for OME [44,60,[70][71][72].…”

Section: Vti Versus Non-vtimentioning

confidence: 99%

“…Five articles compared children that were or were not administered VTI for OME [44,60,[70][71][72]. No differences in speech or language development were observed in short-term (0-5 years) [44,72] or long-term (8-10 years) [70,71] follow-ups. With one exception, all investigators used the same number of CLP children matched for cleft type, age, sex, socioeconomic status, and birth order.…”

Section: Vti Versus Non-vtimentioning

confidence: 99%

See 1 more Smart Citation

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

Kuo¹,

Shiao²

2017

Designing Strategies for Cleft Lip and Palate Care

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The condition of cleft lip/palate (CLP) in children is psychologically stressful for family members and debilitating for the patients themselves. These children must undergo a series of major invasive surgeries following birth, including cleft lip repair surgery, cleft palate repair surgery, bone grafting surgery, and dental implant surgery. Unfortunately, the clinical significance of otitis media with effusion (OME), a complication associated with CLP, is often overlooked, and very few studies have explored this condition in depth. This chapter reviews pathogenesis, clinical manifestations, consequences, examination, and diagnosis related to OME in children with CLP. Controversies surrounding the treatment of OME in CLP children are also discussed. We also provide a flowchart for management guidance in OME in children with CLP.

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Clinical outcomes of ventilation tube placement in children with cleft palate

Cited by 30 publications

References 9 publications

Grommet Surgery in Children with Orofacial Clefts in England

Grommet Surgery in Children with Orofacial Clefts in England

Grommets for Otitis Media With Effusion in Children With Cleft Palate: A Systematic Review

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

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