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

Kuo, Chin‐Lung; Shiao, An‐Suey

doi:10.5772/67122

Cited by 4 publications

(3 citation statements)

References 96 publications

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“…The clinical significance of OME is often overlooked and very few studies have explored this condition in depth, despite the fact that it is commonly associated with CLP. The author summarizes and updates his previous work with the article partly borrowing from the author's earlier publications [4,[9][10][11][12][13][14][15][16][17][18][19][20][21]. This paper presents a review of the pathogenesis, clinical manifestations, and diagnoses of OME in children with CLP as well as the controversies surrounding treatment.…”

Section: Introductionmentioning

confidence: 99%

Glue Ear in Children with Cleft Lip and Palate: An Update

Kuo¹

2018

CMT

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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, including cleft lip repair surgery, cleft palate repair surgery, bone grafting surgery, and/or 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. In this paper, the author reviews the pathogenesis, clinical manifestations, and diagnoses of OME in children with CLP as well as the controversies surrounding treatment. We also provide a flowchart to guide the management of OME in children with CLP.

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Section: Introductionmentioning

confidence: 99%

Glue Ear in Children with Cleft Lip and Palate: An Update

Kuo¹

2018

CMT

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“…Similarly, a randomized control trial showed that only 56% of patients with CLP treated with VTI had improvements in hearing (Zheng et al, 2003). Many studies have also demonstrated spontaneous resolution of OME and eustachian tube dysfunction by 3 to 4 years of age, deeming placement of VTI for hearing improvement unnecessary (Rynnel-Dagöö et al, 1992; Muntz, 1993; Kuo and Shaio, 2017). These results highlight the need for better data on VTI indications and the ability of VTI to successfully curtail hearing loss.…”

Section: Discussionmentioning

confidence: 99%

Tympanostomy Tubes: Are They Necessary? A Systematic Review on Implementation in Cleft Care

Stanton

Kondra

Brahme

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective To understand the indication for and the effects of early ventilation tube insertion (VTI) on hearing and speech for patients with cleft lip and/or palate (CLP). Design We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-guided systematic review of relevant literature. Setting Setting varied by geographical location and level of clinical care across studies. Patients, Participants Patients with CLP who underwent VTI were included. Interventions No interventions were performed. Main Outcome Measure(s) Primary outcome measures were hearing and speech following VTI. Secondary outcome measures were tube-related and middle ear complications. Early VTI occurred before or at time of palatoplasty while late VTI occurred after palatoplasty. Results Twenty-three articles met inclusion criteria. Articles varied among study design, outcome measures, sample size, follow-up, and quality. Few studies demonstrated support for early VTI. Many studies reported no difference in hearing or speech between early and late VTI. Others reported worse outcomes, greater likelihood of complications, or needing repeat VTI following early tympanostomy placement. Several studies had significant limitations, including confounding variables, small sample size, or not reporting on our primary outcome. Conclusions No consistency was found regarding which patients would benefit most from early VTI. Given the aforementioned variability and sub-optimal methodologies, additional studies are warranted to provide stronger evidence regarding VTI timing in cleft care.

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“…3,4 Consequently, they often require multiple major surgeries throughout childhood; however, even with surgical intervention, they can experience persistent comorbidities and complications, including hearing loss and postoperative fistulae, that have detrimental effects on learning and development, and often necessitate long-term monitoring and revision surgeries. 5,6 In addition, they may have persistent speech and communication deficits that can impact social development and quality of life. 7 Revision rates for cleft lip and/or palate (CLP) repair range from 9.6% to 57.4%, 8,9 contributing to a substantial emotional and financial burden for patients and their families.…”

Section: Introductionmentioning

confidence: 99%

From Bedside to Bench and Back: Advancing Our Understanding of the Pathophysiology of Cleft Palate and Implications for the Future

Stanton

Sheridan

Urata

et al. 2022

The Cleft Palate Craniofacial Journal

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Objective To provide a comprehensive understanding of the pathophysiology of cleft palate (CP) and future perspectives. Design Literature review. Setting Setting varied across studies by level of care and geographical locations. Interventions No interventions were performed. Main Outcome Measure(s) Primary outcome measures were to summarize our current understanding of palatogenesis in humans and animal models, the pathophysiology of CP, and potential future treatment modalities. Results Animal research has provided considerable insight into the pathophysiology, molecular and cellular mechanisms of CP that have allowed for the development of novel treatment strategies. However, much work has yet to be done to connect our mouse model investigations and discoveries to CP in humans. The success of innovative strategies for tissue regeneration in mice provides promise for an exciting new avenue for improved and more targeted management of cleft care with precision medicine in patients. However, significant barriers to clinical translation remain. Among the most notable challenges include the differences in some aspects of palatogenesis and tissue repair between mice and humans, suggesting that potential therapies that have worked in animal models may not provide similar benefits to humans. Conclusions Increased translation of pathophysiological and tissue regeneration studies to clinical trials will bridge a wide gap in knowledge between animal models and human disease. By enhancing interaction between basic scientists and clinicians, and employing our animal model findings of disease mechanisms in concert with what we glean in the clinic, we can generate a more targeted and improved treatment algorithm for patients with CP.

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

Cited by 4 publications

References 96 publications

Glue Ear in Children with Cleft Lip and Palate: An Update

Glue Ear in Children with Cleft Lip and Palate: An Update

Tympanostomy Tubes: Are They Necessary? A Systematic Review on Implementation in Cleft Care

From Bedside to Bench and Back: Advancing Our Understanding of the Pathophysiology of Cleft Palate and Implications for the Future

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