Aggressive otologic management has been recommended for children with cleft palate because of the almost universal occurrence of otitis media with effusion (OME) in these children and the association of OME with hearing loss and possible language, cognitive, and academic delays. In this study, 28 children with cleft palate and 29 noncleft children were seen at 3-month intervals from 9 to 30 months to compare otologic treatment and management. Hearing and middle ear function were tested at each session; information on ventilation tube placement was obtained from medical records. Ventilation tubes were placed earlier and more often in children with cleft palate, but children with cleft palates failed the hearing screening more often. The correlation between age at first tube placement and frequency of hearing screening failures was significant for the children with cleft palate, indicating that the later tubes were first placed, the poorer the child's hearing.

Aggressive otologic management has been recommended for children with cleft palate because of the almost universal occurrence of otitis media with effusion (OME) in these children and the association of OME with hearing loss and possible language, cognitive, and academic delays. In this study, 28 children with cleft palate and 29 noncleft children were seen at 3-month intervals from 9 to 30 months to compare otologic treatment and management. Hearing and middle ear function were tested at each session; information on ventilation tube placement was obtained from medical records. Ventilation tubes were placed earlier and more often in children with cleft palate, but children with cleft palates failed the hearing screening more often. The correlation between age at first tube placement and frequency of hearing screening failures was significant for the children with cleft palate, indicating that the later tubes were first placed, the poorer the child's hearing.

This experiment assessed the extent to which a peripheral hearing loss may confound interpretation of dichotic listening test results in assessment of central auditory deficit. A normal-hearing listener was tested monotically and dichotically with CV nonsense syllables in two conditions. In one, an EAR plug was inserted in the auditory canal to simulate a unilateral conductive hearing loss. In the second, no plus was inserted. Syllables were presented with equal intensity to the two ears for dichotic testing and testing was conducted at several different intensities. With the plug inserted, both magnitude and direction of percent ear advantage varied with test intensity even when monotic speech recognition scores exceeded 95% for both ears. When dichotic tests are used to assess central auditory deficit in patients with peripheral hearing loss, we recommend that the test intensity be at least 10 dB from both the lower and upper knees of monotic performance-intensity functions.