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Cleft palate did not raise ventilation tube insertion complication rate
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Recent data show complication rates for ventilation tube insertion did not differ among children with or without cleft lip or palate, indicating treatment guidelines should not differ.
Ian Smillie, MRCS Ed, of the Royal Hospital for Sick Children in Glasgow, Scotland, and colleagues compared 60 patients with cleft lip or palate (CLP) who underwent ventilation tube insertion with patients who underwent the same procedure but did not have CLP. Median age at time of surgery was 3.5 years. Surgeries occurred between May 2002 and October 2012.
There were 146 complications among children with CLP, with a mean of 2.4 complications per child. Children without CLP experienced 194 complications, with a mean of 3.2 complications per child.
Otorrhea rates were higher among children without CLP; 151 episodes occurred among children without CLP vs. 121 among children with CLP. Children with CLP had a mean number of two otorrhea episodes per child compared with 2.5 per child without CLP. Thirty-eight percent of children with CLP and 40% of children without CLP did not experience otorrhea.
There was a significant negative correlation between increased age and otorrhea rate. Otorrhea rates were higher among children younger than 2 years in both groups. Children without CLP, aged 1 to 1.9 years, had the highest mean rate of otorrhea (seven episodes per patient).
The number of other complications was higher among children without CLP.
Children with CLP had more visits from the pediatric otorhinolaryngology team regarding general review than children without CLP. However, there was no significant difference in otorhinolaryngology team attendance for complications.
Average follow-up for children with CLP was 2.95 years vs. 2.2 years for children without CLP.
“Our findings are the best evidence available to measure the effect of CLP on complication rates. Ultimately, this study has shown that complications are not higher within the CLP treatment group, and therefore patients with CLP should be treated for acute otitis media and otitis media with exposure in the same way as non-CLP patients,” the researchers concluded.
Disclosure: The researchers reported no relevant financial disclosures.
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