The Utility of Pneumatic Cavity Volume in the Treatment of Exudative Otitis Media in Children with Cleft Palate.

OBJECTIVE: Measure the volume of air-containing space in children with cleft palate and assess age-related changes, recurrence rate of otitis media with effusion (OME) after tube removal, and temporal bone development trend based on time of tube placement. DESIGN: Interventional prospective study. SETTING: Cleft Lip and Palate Center at a Tertiary-level institution. PATIENTS/PARTICIPANTS: One hundred sixty-eight ears of 86 patients who visited our center from January 2018 to December 2019. INTERVENTIONS: We performed tympanometry (impedance audiometry) after tube placement. MAIN OUTCOME MEASURES: Recurrence (at least one episode of OME after tympanic membrane closure), tympanic cavity volumes, and timing of tube placement. RESULTS: The mean air-containing cavity volume was 1.62 mL, 2.99 mL, and 3.29 mL in patients aged 1, 2, and 3 years, respectively. A rapid increase in volume was observed around 2 years of age. Twenty-two (42.3%) of the 52 ears with pneumatic cavity volumes <3 mL, and four (14.3%) of the 28 ears with pneumatic cavity volumes ≥3 mL had recurrence. Tubes were placed at ages <1 year and ≥1 year in 28 and 62 ears, respectively. The pneumatic cavity volume tended to be greater in the ears with tube placement at age <1 year. CONCLUSION: This study provided insights into using pneumatic cavity volume measurements to determine the appropriate timing for tube removal. Tubes should be placed as early as possible (before the age of 2 years) for prolonged OME associated with children with cleft palate.