Outcome of the ‘waiting until spontaneous extrusion’ strategy for long-term tympanostomy tube placement in children with cleft palate

Abstract

Background

Otitis media with effusion (OME) in children with cleft palate (CP) is known to be refractory to treatment and most of these patients undergo surgery for ventilation tube (VT) placement.

Objectives

To identify the outcomes of children with CP using long-term VT with a ‘waiting until spontaneous extrusion’ strategy.

Material and methods

We retrospectively reviewed the medical records of all children with CP who visited our department from December 2016 to November 2017 and who received long-term VT placement in our department. Risk factors related to residual perforation and recurrence of OME were analyzed.

Results

A total of 106 children were included in this study. Our statistical analysis of 94 ears followed for more than three months after VT loss revealed that longer VT placement was associated with residual perforation, and shorter VT placement was associated with OME recurrence. Although a longer duration of VT placement was associated with an increased rate, extremely long-term VT placement was not associated with residual perforation, as expected. Half of the VTs were spontaneously extruded at 40 months after insertion.

Conclusions and Significance

Long-term VT insertion using a waiting until spontaneous extrusion strategy is a potential option for children with CP.

Chinese Abstract

背景：已知腭裂 (CP) 儿童积液性中耳炎 (OME) 难以治疗, 多数这样的患者接受放置通气管 (VT) 的手术。

目的：确定 CP儿童使用长期 VT 及“等到自发挤出”策略的结果。

材料与方法：我们回顾性检查了所有2016年12月至2017年11月来我科就诊, 并在这里安装长期VT的CP儿童的病历。分析了残留穿孔和OME复发的相关危险因素。

结果：本研究共纳入 106 名儿童。我们对 94 只耳朵进行了统计分析, 在 VT 丢失后三个多月的时间显示, 较长的 VT 放置与残余穿孔有关, 较短的 VT 放置与 OME 复发有关。虽然更长VT 放置的持续时间与增加的比率相关, 极长期的 V​​T 放置, 正如预期的那样, 与残余穿孔无关。一半VT 在插入后 40 个月自发挤出。

结论和意义：使用长期 VT 插入直到自发挤出策略是 CP儿童的潜在选择。

Keywords:

• Cleft palate
• OME
• perforation
• ventilation tube

Disclosure statement

No potential conflict of interest was reported by the author(s).