Otitis media with effusion in children with cleft lip and palate: a narrative review.
OBJECTIVE
Repair surgery of cleft lip and palate (CLP) can produce satisfactory cosmetic results but the problem of recurrent otitis media with effusion (OME) secondary to CLP may persist. This can cause long-term hearing loss and affect linguistic, academic, and personal development. The aim of this review is to provide the most recent information regarding OME in children with CLP.


METHODS
All papers referring to children with CLP and OME were identified from searches in Medline, PubMed, Cochrane Library, and Web of Science. Abstracts were read and relevant papers were obtained. Additional studies were obtained from the references of the selected articles.


RESULTS
Both current and previous research on OME in children with CLP focused on the controversy over treatment strategies. Evidence on the optimal treatment for OME in CLP children was lacking. Ventilation tube surgery using the same anesthetic as lip or palate procedures was not well-supported. After summarizing the literature review, a flowchart of management guidance for such patients is also recommended. Updated reviews such as this will provide clinicians and patients/parents with a valuable reference.


CONCLUSIONS
The lack of evidence on the optimal treatment for OME in children with CLP should prompt a relatively conservative approach. However, only a consensus between patients/parents and surgeons regarding the most suitable treatment strategy for OME can ensure the greatest benefit to individual patients.
Department of Otorhinolaryngology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, ROC.
Chin-Lung
CL
Kuo
Chiang-Feng
CF
Lien
Chia-Huei
CH
Chu
An-Suey
AS
Shiao
D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002972:Cleft Palate / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D034381:Hearing Loss / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008876:Middle Ear Ventilation / Q000379:methods; D033262:Narration; D010034:Otitis Media with Effusion / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D057832:Watchful Waiting
Cleft lip and palate; Conductive hearing loss; Grommet tube; Middle ear effusion; Otitis media