Long-term audiologic and speech developmental outcomes following ventilation tube insertion in children with otitis media with effusion and cleft palate: a prospective non-randomized study.

BACKGROUND

Cleft palate (CP) with otitis media with effusion (OME) often cause persistent conductive hearing loss, increasing the risk of long-term speech-language delay and social difficulties if untreated. While ventilation tube (VT) insertion is recommended for recurrent or persistent OME with significant hearing loss, its long-term benefits in CP remain unclear.

OBJECTIVES

To address the long-term effects of VT insertion on audiologic and speech-language development in children with CP and OME.

MATERIALS AND

METHODS

In this non-randomized controlled study, 154 children aged 1-4 years with CP and OME were enrolled. The VT group (n = 74) received VT insertion during or after palatoplasty, while the conservative group (n = 80) underwent palatoplasty alone. Assessments at 3, 6, 12, 18, 24, and 36 months included air-bone gap, tympanogram, speech recognition in quiet/noise (SRS, SRN), speech clarity, and developmental scale scores (MUSS, SIR, MCDI).

RESULTS

Over 36 months, the VT group showed greater improvement in air-bone gap and tympanogram normalization (q < 0.001) and higher speech clarity from 18 months (q < 0.05). MUSS, SIR, and MCDI scores were superior from 12 months onward.

CONCLUSIONS AND SIGNIFICANCE: Early VT insertion with palatoplasty provides sustained hearing and speech-language benefits, supporting its integration into management for CP with OME.