The effect of the palatoplasty method on the frequency of ear tube placement

Lynnelle K Smith, Samuel P Gubbels, Carol J MacArthur, Henry A Milczuk
Archives of Otolaryngology—Head & Neck Surgery 2008, 134 (10): 1085-9

OBJECTIVE: To determine whether the type of palate repair affects the frequency of subsequent ventilation tube placement.

DESIGN: Combined retrospective and prospective cohort with more than 2 years clinical follow-up after palatoplasty.

SETTING: Tertiary care children's hospital and clinic.

PATIENTS: A total of 170 patients with cleft palate (with or without cleft lip) underwent palatoplasty between 1995 and 2003. Sixty-nine patients with less than 2 years of follow-up visits and 1 patient who did not require ear tubes were excluded from this analysis.

INTERVENTIONS: Either traditional 2-flap palatoplasty (group A) or double-opposing Z-plasty (group B) was performed. The type of palatoplasty performed was based on the reconstructive surgeon's clinical decision. Ventilation tubes were placed for otitis media, conductive hearing loss, or eustachian tube dysfunction. Patients received routine follow-up care every 6 months or whenever acute problems arose. Data were analyzed with independent t tests, chi(2) tests, and Fisher exact tests.

MAIN OUTCOME MEASURES: Number of ear tubes placed after palatoplasty in each group.

RESULTS: Group A had a mean (SE) of 2.9 (0.2) sets of tubes placed, while group B had a mean (SE) of 1.8 (0.2) sets of tubes. Group A had significantly more sets of ventilation tubes placed (P < .001) than group B. Subgroup analysis based on type of cleft was performed.

CONCLUSION: Children with cleft palate who underwent double-opposing Z-plasty had fewer sets of ear tubes placed postoperatively than patients who had traditional repair.

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