Conservative management versus ventilation tube insertion in children with otitis media with effusion accompanying cleft palate

Background and Aim: Otitis media with effusion (OME) usually affects ∼92–97% of children experiencing cleft palate during their first year. The wide incidence of OME in cleft palate has largely been owing to dysfunction of the Eustachian tube. The aim of this study is to evaluate and compare the outcome of ventilation tube insertion versus conservative management in patients with cleft palate complaining of hearing affection. Patients and methods: This is a prospective cohort study carried out in the Department of Otorhinolaryngology at Luxor International Hospital at Luxor in the period from May 2019 to May 2020. A total of 20 children with cleft palate having OME were chosen. Overall, 10 patients were subjected to ventilation tube insertion after repair, and 10 patients were subjected to conservative management. Complete investigations were done including tympanometry and hearing assessment by audiometry or Auditory Brain stem Response Test (ABR). All cases were followed up by tympanometry before and after repair and after 3 months of repair. Results: According to our study, there was a statistically significance relationship between hearing improvement and ventilation tube insertion after 3 months of repair measured by tympanometry, where 60% of the patients transformed to type B tympanometry but only 40% still had type A tympanogram (P=0.006). There was a statistically significance relationship between hearing improvement and ventilation tube insertion after 3 months of repair measured by audiogram, where it was better in group B, where mean±SD was 26±12.6 (P=0.007). Conclusion: Equated with conservative management, Ventilation tube insertion (VTI) is beneficial to hearing recovery. There is a belief that the early VTI at the time of palatoplasty surgery is beneficial; however, there is insignificant evidence indicating the best timing for VTI.