Centre-level variation in outcomes and treatment for otitis media with effusion and hearing loss and the association of hearing loss with developmental outcomes at ages 5 and 7 years in children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 2

Amanda Hall, Andrew Wills, Osama Mahmoud, D Sell, Andrea Waylen, Sukhraj Singh Grewal, Jonathan Sandy, Andrew R Ness

Research output: Contribution to journalArticle (Academic Journal)

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Abstract

ObjectivesTo explore centre-level variation in otitis media with effusion (OME), hearing loss and treatments in children in Cleft Care UK (CCUK) and to examine the association between OME, hearing loss and developmental outcomes at 5 and 7 years.Setting and Sample PopulationTwo hundred and sixty-eight 5-year-old British children with non-syndromic unilateral cleft lip and palate (UCLP) recruited to CCUK.Materials and MethodsChildren had air and bone conduction audiometry at age 5. Information on grommet and hearing aid treatment was obtained from parental questionnaire and medical notes. Hearing loss at age 5 was defined as >20 dB in the better ear and history of OME and hearing loss was determined from past treatment. Children with sensorineural hearing loss were excluded. Associations were examined with speech, behaviour and self-confidence at age 5 and educational attainment at age 7. Centre variation was examined using hierarchical models and associations between hearing variables and developmental outcomes were examined using logistic regression.ResultsThere was centre-level variation in early grommet placement (variance partition coefficient (VPC) 18%, P=.001) and fitting of hearing aids (VPC 8%, P=.03). A history of OME and hearing loss was associated with poor intelligibility of speech (adjusted odds ratio=2.87, 95% CI 1.42-5.77) and aspects of educational attainment.ConclusionsHearing loss is an important determinant of poor speech and treatment variation across centres suggest management of OME and hearing loss could be improved.
Original languageEnglish
Pages (from-to)8-18
Number of pages11
JournalOrthodontics and Craniofacial Research
Volume20
Issue numberS2
Early online date29 Jun 2017
DOIs
Publication statusPublished - Jun 2017

Bibliographical note

Special Issue: Determinants of outcomes in a centralised service: the Cleft Care UK study

Keywords

  • centralization;
  • DEVELOPMENTAL OUTCOMES
  • hearing loss
  • unilateral cleft lip and palate

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