Comparison of the Hearing Histories of Children with and without Cleft Palate

Abstract

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.

Tympanostomy Tube Placement for Otitis Media with Effusion in Children with Cleft Lip and Palate

“…This assumption is supported by several studies [67,71,88], in which a relationship was established between the degree of clefting and the frequency of VTI, with severe or complete clefts more likely to involve grommet insertion. Children with cleft palate had a significantly higher frequency of VTIs than those without [51,59]. However, this issue requires further investigation.…”

“…Several prospective [51,59,60] and retrospective [20,44,46,52,[61][62][63][64][65][66][67][68] cohort studies evaluated hearing outcomes. Among these cohort studies, several studies compared VTI with non-VTI (i.e., myringotomy alone, hearing aids, watchful waiting) [44,60,62,[64][65][66][67][68].…”

“…Four articles reported in post-VTI middle ear function in CLP and non-CLP children [51,52,59,69], three of which included an age-matched non-CLP control group [51,52,69]. The results in studies by Ovesen and Blegvad-Andersen [52] and Broen et al [59] were not considered for further interpretation because only 6 and 31% of the non-CLP children with OME underwent VTI, respectively.…”

“…The results in studies by Ovesen and Blegvad-Andersen [52] and Broen et al [59] were not considered for further interpretation because only 6 and 31% of the non-CLP children with OME underwent VTI, respectively. Merrick et al reported comparable rates of persistent OME in children with and without cleft palate (24% versus 14%, p = 0.31) [69].…”

“…A significant proportion (53.2-98%) of CLP children with OME required VTI [4,51,54,61,78] with an average of between 0.55 and 2.2 VTIs per patient in the first 7 years of observation [20,44,59,66]. Cleft defects play an important role in OME formation; therefore, it would be reasonable to assume a higher need for grommets in children with more overt palatal malformations.…”