(413) Race and Hearing Interventions in Pediatric Patients with Cleft Palate

Monday, October 2, 2023

2:45 PM – 3:45 PM East Coast USA Time

Has Audio

Presenting Author(s)

Lindsey Katelyn Greenlund, BS

Medical Student
University of Minnesota Medical School
Lauderdale, Minnesota, United States

Co-Author(s)

SC

Siva Chinnadurai, MD, MPH

Assistant Professor
Children's Minnesota, USA
RT

Robert J. Tibesar, MD

Assistant Professor
Children’s Minnesota Hospitals Department of Pediatric Otolaryngology & Facial Plastics
Minneapolis, Minnesota, United States
NM

Noelle Morrell, CCC, SLP

Speech and Language Pathologist
Children's Minnesota
Minneapolis, Minnesota, USA

Senior Author(s)

Brianne Roby, MD, FACS

Associate Professor
Children's Minnesota
St. Paul, Minnesota, United States

Disclosure(s):

Lindsey Katelyn Greenlund, BS: No relevant relationships to disclose.

Robert J. Tibesar, MD: No relevant relationships to disclose.

Noelle Morrell, CCC, SLP: No relevant relationships to disclose.

Brianne Roby, MD, FACS: No relevant relationships to disclose.

Introduction: A common comorbid complication of cleft palate is pediatric otitis media. Fluid buildup often requires pressure equalization tubes (PETs). Some surgeons elect to place these tubes at 2-months of age while others wait until 6- to 12-months of age. There are no formal guidelines on the ideal timing of PET placement. However, it is thought that the earlier tubes are placed, the more months of normal hearing patients gain. To date, there have been no studies assessing the impact of race on the timing of PET placement in pediatric patients with cleft palate- we sought to explore this knowledge gap. We hypothesized that Black or Hispanic/Latino patients may receive PETs later than White patients.

Methods: A retrospective chart review of all patients with a cleft palate diagnosis (ICD-10 code: Q37.9) between 11/22/2016 and 11/22/2021 at a tertiary children's institution was conducted. 790 patients were included. Demographics, cleft palate reconstructive surgery details, and PET placements were collected and analyzed based on patient-reported race.

Results: No statistically significant differences were found in the timing of PET placement based on race in patients with cleft palate. In 57 Black patients, 31 (54.4%) and 15 (26.3%) received PETs at ≤ 6-months and >6-months, respectively. 11 Black patients (19.3%) did not receive PETs. Out of 29 Hispanic/Latino, 12 (41.4%) and 12 (41.4%) patients, at ≤ 6-months and >6-months, respectively. 5 (17.2%) did not receive PETs. Out of 504 White patients, 180 (35.7%) got PETs at ≤6-months, 238 (47.2%) at >6-months, and 144 (28.6%) did not receive PETs.

Conclusions: This is the first study to explore race-based differences in PET placement. We found that there are no significant race-based differences in the timing of PET placement in this cohort. Regardless, it is essential to continue advocating for equity in care. A limitation of this study is our predominantly White patient population. Future directions include expanding this study to other procedures within our institution and assessing PET placement at multiple institutions to further understand race-based differences in care.