Tympanostomy Tubes: Are They Necessary? A Systematic Review on Implementation in Cleft Care.

Objective: To understand the indication for and the effects of early ventilation tube insertion (VTI) on hearing and speech for patients with cleft lip and/or palate (CLP). Design: We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-guided systematic review of...

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Publicado en:Cleft Palate Craniofacial Journal Vol. 60; no. 4; pp. 430 - 446
Autores principales: Stanton, Eloise, Kondra, Katelyn, Brahme, Indraneel, Lasky, Sasha, Munabi, Naikhoba C.O., Jimenez, Christian, Jacob, Laya, Urata, Mark M., Hammoudeh, Jeffrey A., Magee III, William P.
Formato: research systematic review tables/charts Journal Article
Publicado: Sage Publications Inc. Apr2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2023
      vid: 60
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Tympanostomy Tubes: Are They Necessary? A Systematic Review on Implementation in Cleft Care.
      aug:
        au:
          Stanton, Eloise
          Kondra, Katelyn
          Brahme, Indraneel
          Lasky, Sasha
          Munabi, Naikhoba C.O.
          Jimenez, Christian
          Jacob, Laya
          Urata, Mark M.
          Hammoudeh, Jeffrey A.
          Magee III, William P.
        affil: 5150Children's Hospital Los Angeles, Los Angeles, CA, USA
      sug:
        subj:
          Early Childhood Intervention
          Middle Ear Ventilation Equipment and Supplies
          Treatment Outcomes
          Hearing
          Speech
          Implementation Science
          Cleft Lip
          Cleft Palate
          Patient Care
          Human
          Systematic Review
          Cleft Palate Surgery
          Equipment Failure
          Otitis Media Surgery
      ab: Objective: To understand the indication for and the effects of early ventilation tube insertion (VTI) on hearing and speech for patients with cleft lip and/or palate (CLP). Design: We conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-guided systematic review of relevant literature. Setting: Setting varied by geographical location and level of clinical care across studies. Patients, Participants: Patients with CLP who underwent VTI were included. Interventions: No interventions were performed. Main Outcome Measure(s): Primary outcome measures were hearing and speech following VTI. Secondary outcome measures were tube-related and middle ear complications. Early VTI occurred before or at time of palatoplasty while late VTI occurred after palatoplasty. Results: Twenty-three articles met inclusion criteria. Articles varied among study design, outcome measures, sample size, follow-up, and quality. Few studies demonstrated support for early VTI. Many studies reported no difference in hearing or speech between early and late VTI. Others reported worse outcomes, greater likelihood of complications, or needing repeat VTI following early tympanostomy placement. Several studies had significant limitations, including confounding variables, small sample size, or not reporting on our primary outcome. Conclusions: No consistency was found regarding which patients would benefit most from early VTI. Given the aforementioned variability and sub-optimal methodologies, additional studies are warranted to provide stronger evidence regarding VTI timing in cleft care.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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