Impact of Tympanostomy Tube Placement on Hearing Outcomes in Children With Cleft Palate-Related Otitis Media: Retrospective Analysis of a Primary Single-Stage Cleft Palate Repair Cohort

Background: Children with cleft palate commonly experience otitis media with effusion (OME), leading to conductive hearing loss. The effectiveness of tympanostomy tube placement in improving hearing outcomes in this population remains limited. Methods: A retrospective cohort study included 44 non-syndromic children undergoing primary single-stage cleft palate repair at Maastricht University Medical Centre. Tympanostomy tubes were placed during primary surgery. The primary outcome was the change in hearing thresholds post-intervention. Secondary outcomes included OME prevalence, hearing loss type, frequency of tube placements, and tympanic membrane abnormalities. Results: OME was present in 88.6% of patients. Conductive hearing loss was found in 31.8% and sensorineural loss in 4.5%. A significant mean improvement of 14.13 dB (P < .001) was observed post-intervention. No significant difference was found between ears (P = .916). Random intercept variance at the child level was 49.07 (standard deviation = 7.00), indicating substantial interindividual variability. Tympanic membrane abnormalities were observed in patients with repeated tube placements, but did not cause long-term hearing deterioration. Conclusion: Tympanostomy tube placement improves hearing outcomes in children with cleft palate. When OME is present at the time of cleft surgery or there is a documented history of recurrent OME or acute otitis media, concurrent tube placement should be considered to alleviate conductive hearing loss. Prospective studies are warranted to confirm these findings and optimize care.