Is otitis media with effusion almost always accompanying cleft palate in children?: the experience of 319 Asian patients.

摘要

OBJECTIVES/HYPOTHESIS: To evaluate the incidence of concomitant otitis media with effusion (OME) in children with cleft palate in Taiwan and the reliability of preoperative tympanometry. STUDY DESIGN: Individual prospective cohort study. METHODS: We included 319 patients who underwent palatoplasty for cleft palate from 2005 to 2010. All received tympanometry 1 day before surgery, and myringotomy was performed before palatoplasty. Grommet was inserted if there was OME, the amount and content of which were graded and recorded. All data, including the tympanometry results, were analyzed for statistical significance. RESULTS: The incidence of OME accompanying cleft palate during palatoplasty was 71.92% in Asian patients, which was lower than in previous studies. The content of OME was serous fluid in 47.8%, mucoid in 33.1%, and mucopus in 19.1%. Type-B tympanogram had high sensitivity (0.956) in all age groups. However, its specificity was poor in children younger than 9 months (0.375), fair in children aged 9 to 14 months (0.582), and good in children older than 14 months (0.857). CONCLUSIONS: The incidence of OME accompanying cleft palate has decreased in Asian patients in the past 5 years. Tympanometry is not a very reliable tool for evaluating OME in children with cleft palate younger than 14 months, especially those younger than 9 months. Meticulous examination of the middle ear during palatoplasty is necessary for making a definite diagnosis and deciding on the use of a grommet.