title: The effect of early routine grommet insertion on management of otitis media with effusion in children with cleft palate.
abstract: OBJECTIVE
  The aim of the study is to compare long term otoscopic and audiological findings of cleft palate patients with or without early grommet insertion.
  
  
  METHODS
  Cleft palate patients followed-up in Hacettepe University between 2008 and 2013 were included in the study. Age, gender, cleft types and palate surgery data, grommet tube insertion history and otological - audiological evaluations of the patients were recorded. Patients were evaluated in three groups according to grommet insertion history: A-early routine grommet insertion, B-grommet insertion during follow-up, C-no grommet insertion. Otological and audiological findings were compared.
  
  
  RESULTS
  There were 154 patients in the study, with a median age of 7.7 years. There were 67 patients in group A (43.5%), 22 patients in group B (14.3%) and 65 patients in group C (42.2%). OME was identified significantly higher in group A and normal otoscopic examination findings were higher in group C. Complications showed a higher rate than other otoscopic findings in group B patients. There was no significant difference for any frequencies in between the groups in terms of mean air-bone gap (ABG) values. There were 20 grade I, 25 grade II, 77 grade III and 32 grade IV patients in the study according to the Veau classification.
  
  
  CONCLUSIONS
  Prophylactic grommet insertion may not be applied as some cleft palate patients with no OME. Wait and see protocol can be recommended for these patients, and they should be followed-up up closely to avoid complications. If the effusion does not recover or tympanic membrane changes occur in follow-up, grommet insertion should be considered.
authors.affiliation: Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: drkuscu@gmail.com.
authors.forename: Oğuz
authors.initials: O
authors.lastname: Kuşcu
authors.affiliation: Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: rogunaydin@gmail.com.
authors.forename: Rıza Önder
authors.initials: RÖ
authors.lastname: Günaydın
authors.affiliation: Hacettepe University, Department of Otorhinolaryngology, Audiology and Speech Pathology Unit, Ankara, Turkey. Electronic address: mehtap_ozturk06@hotmail.com.
authors.forename: Mehtap
authors.initials: M
authors.lastname: İcen
authors.affiliation: Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: ergunooc@yahoo.com.
authors.forename: Onur
authors.initials: O
authors.lastname: Ergün
authors.affiliation: Hacettepe University, Department of Otorhinolaryngology, Audiology and Speech Pathology Unit, Ankara, Turkey. Electronic address: mavis@hacettepe.edu.tr.
authors.forename: Mavis Emel
authors.initials: ME
authors.lastname: Kulak Kayikci
authors.affiliation: Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: tyilmaz@hacettepe.edu.tr.
authors.forename: Taner
authors.initials: T
authors.lastname: Yılmaz
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hacettepe University Medical School, Ankara, Turkey. Electronic address: fozgur@hacettepe.edu.tr.
authors.forename: Fatma Figen
authors.initials: FF
authors.lastname: Özgür
authors.affiliation: Hacettepe University, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: umutakyol@yahoo.com.
authors.forename: Mehmet Umut
authors.initials: MU
authors.lastname: Akyol
mesh_terms: D002648:Child; D002972:Cleft Palate / Q000150:complications*; D006801:Humans; D008876:Middle Ear Ventilation / Q000379:methods*; D010034:Otitis Media with Effusion / Q000601:surgery*
keywords: Cleft palate; Effusion; Grommet tube; Otitis media