Rational management of middle ear effusions in the cleft palate patient.

Middle ear effusions are common prior to surgical repair of a congenital cleft of the secondary palate. The insertion of middle ear ventilating tubes will result in an aerated middle ear, but significant complications will also occur. A review of 57 infants suggests that these ventilating tubes rarely need to be inserted prior to palatal closure but only if there is persistence of middle ear fluid three months after such surgery.