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.

Hearing and speech assessment of cleft palate patients after palatal closure

“…Mild and moderate conductive fluctuating hearing loss is well described to be one of the major problems in cleft palate population [14,15]. It has been suggested that because our cleft palate patients after 1-stage palatoplasty suffered, at a great percentage (69%), from mild to moderate hearing loss, their early persistent seromucous otitis may be responsible not only for the later otologic abnormalities and hearing impairment but also for their reportedly prevalent impairment at speech and language.…”

The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts

“…OME is associated with a mild to moderate conductive hearing loss with levels fluctuating between 0 and 55 dB across the speech frequencies [14]. In the four previously cited studies, all have reported hearing sensitivity, with only two relating it to OME [12,24]. The two studies had opposing findings.…”

“…The two studies had opposing findings. Valtonen et al [24] found ears with OME demonstrated a low percent of hearing loss (PTA > 15 dB); while Broen et al [12] found children with clefts and who had failed tympanometry demonstrated poorer hearing thresholds than children who passed tympanometry.…”

“…Four studies have prospectively gathered data on children with CLP and demonstrated a higher prevalence of OME in children with CLP though abnormal tympanometry or abnormal otomicroscopy [6,12,23,24]. However, these studies either examined children which were younger than the documented peak of prevalence of 4-6 years of age [8], or they were older and not longitudinally followed.…”

“…Since OME is a common childhood ailment, it is integral to have a group of children without CLP to obtain an estimation of the difference in prevalence of OME. Only three studies to date have compared children with CLP to children without cleft [12,24,25], but these studies have included different subject groups, different types of clefts, and did not examine the children for the length of time required to explore the prevalence of OME in regards to age. This needs to be completed to give insight into providing the best audiological and otological management for children with cleft lip and palate with a comparison to children without cleft over the first several years of life.…”