Resolution of Otitis Media with Effusion in Children with Cleft Palate Followed through Five Years of Age

Abstract

Objective To describe the temporal pattern of otitis media with effusion (OME) resolution for a cohort of nonsyndromic cleft palate children enrolled before palatoplasty and followed through 5 years of age. Design This is a prospective, longitudinal study of the time course for OME resolution in infants and children with palatal clefts. Setting Cleft Palate Craniofacial Center of a tertiary care pediatric hospital. Participants This study included 52 children with cleft palate (29 boys, 45 white, Veau 1 through 4) who had a Furlow-type palatoplasty between 10 and 24 months of age performed by one of six surgeons. Interventions Standard cleft palate management was supplemented with study visits to the research clinic pre- and postpalatoplasty and then yearly to 6 years of age for assessments of middle ear status by interval history, otoscopy, and tympanometry. Main Outcome Measure The main outcome measure was age at otitis media resolution defined as the age in years at the first in a sequence of “disease-free” diagnoses not interrupted or followed by any other diagnosis. Results The cumulative percent OME resolution for ears/children at ages <1, 1, 2, 3, 4, 5 years was 4.1/4.4, 14.3/10.9, 31.6/21.7, 45.9/37.0, 56.1/50.0, and 70.4/60.9%. OME resolution followed a simple linear time curve with slopes of 13.5% (confidence interval [CI] = 12.2% to 14.8%, r2 = .99) and 11.9% (CI = 10.1% to 13.6%, r2 = .99) resolutions per year for ears and children, respectively. Conclusions There is a natural, age-related pattern of resolution for persistent OME that affects most infants and young children with cleft palate that is not affected by palatoplasty.