Risk Factors for Otitis Media in Pediatric Patients With Cleft Lip and/or Cleft Palate: Systematic Review and Meta-analysis

Abstract

Objective

To evaluate risk factors for otitis media (OM) in children with cleft lip and/or palate (CL/P).

Design

Systematic review of MEDLINE, Embase, Cochrane, CINAHL, and Web of Science using PRISMA guidelines. Meta-analysis was performed using RevMan5.4.1.

Setting

Eligible studies included cross-sectional, retrospective, and prospective studies.

Patients/Participants

Pediatric patients with CL/P who develop OM.

Interventions

OM risk factors including age, gender, and cleft type and size.

Main Outcome Measure(s)

Incidence of OM.

Results

Eighteen studies involving 2272 children with CL/P were included. Pooled results showed no statistically significant difference in OM incidence between male and female children with CL/P (OR: 1.16; 95% CI: 0.80-1.60; P = .44). There was no significant difference in OM incidence between patients aged 2 years and below and those aged above 2 years (OR: 2.14; 95% CI: 0.33-13.83; P = .42). Cleft lip and palate (CLP) patients demonstrated significantly higher incidences of OM than cleft palate (CP) (OR: 1.58; 95% CI: 1.09-2.29; P = .02) and cleft lip (CL) patients (OR: 8.26; 95% CI: 2.21-30.90; P = .002). CP-only patients also demonstrated significantly higher OM incidences than CL-only patients (OR: 22.30; 95% CI: 8.40-59.21; P < .00001). Moreover, CPs classified as Veau III and IV showed higher OM incidences than those classified as Veau I and II (OR: 0.32; 95% CI: 0.18-0.58; P = .0001 and OR: 0.51; 95% CI: 0.33-0.77; P = .001, respectively).

Conclusion

CLP and CP alone are significant risk factors for developing OM in children, but not age and sex.