Grommet Surgery in Children with Orofacial Clefts in England

Objective To assess grommet insertion practice in the first 5 years of life among children with an orofacial cleft in England. Design Analysis of national administrative data of hospital admissions. Setting National Health Service hospitals, England. Patients Patients born between 1997 and 2005 who underwent surgical cleft repair. Intervention Children receiving grommets before the age of 5 years. Outcome Measures The proportion of children receiving grommets before the age of 5 years, the timing of the first grommet insertion, and the proportion of children having repeat grommet insertions were examined according to cleft type, the absence or presence of additional anomalies, socioeconomic deprivation, and region of residence. Results The study included 8,269 children. Before the age of 5 years, 3,015 (36.5%) children received grommets. Of these, 33.2% received their first grommets at primary cleft repair and 33.3% underwent multiple grommet insertion procedures. The most common age for the first procedure was between 6 and 12 months. Children with a cleft affecting the palate were more likely to receive grommets than children with a cleft lip alone (45.5% versus 4.5%). Grommet insertion practice also varied according to year of birth, absence or presence of additional anomalies, socioeconomic deprivation, and region of residence. Conclusion Grommets practice in children with a cleft appears to vary according to their clinical characteristics. The differences in practice observed according to deprivation and region of residence need to be further explored.