Problems of middle ear and hearing in cleft children

Abstract

The hearing loss in a cleft patient is a well known complication, but generally gets ignored. These children continue to have recurrent otitis media with effusion that affects the hearing abilities. Unfortunatley the middle ear function may not improve with palatoplasty.Cleft palate teams need to follow up all such children beginning at birth and going into adulthood, decades after a ‘successful’ palate repair. These patients should have careful otological and audiological surveillance with appropriate interventions whenever required. The review article discusses the current status of hearing management in patients with cleft palate.

Auditory Brainstem Responses in Newborns With Complete Cleft Palate and Lip at a Japanese Perinatal Center

“…These inflammatory changes result in otitis media leading to conductive hearing loss in patients with cleft palate [5]. However, the current results indicate the presence of congenital conductive hearing disturbance in newborns with complete cleft palate and lip before the development of serous otitis media.…”

“…The abnormal reflux of food and fluid into the nasal cavity can set up chronic inflammatory changes such as edema, hypertrophy, obstruction and secondary middle ear disease [5]. These inflammatory changes result in otitis media leading to conductive hearing loss in patients with cleft palate [5].…”

“…Hearing loss is a well-known complication of cleft palate, but the magnitude of this problem is not generally appreciated [5]. A lot of attention has been paid to the development of a competent velopharyngeal port and normal facial development in these children.…”

“…A lot of attention has been paid to the development of a competent velopharyngeal port and normal facial development in these children. This concern with the production of normal speech and the prevention of facial deformity has diverted attention from a common but unfortunately ignored complication of hearing loss [5].…”

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

“…Despite the fact that a number of reviews have been published on treatment choices for the management of OME in CLP children, a number of these are narrative reviews [3,6,[96][97][98], whereas others are systematic reviews pertaining mainly to otherwise healthy children [27,45,77,95,[99][100][101][102][103][104][105]. The lack of research on the CLP subgroup of children means that there is currently no evidence-based information for clinicians or parents with regard to the effectiveness of grommets for OME in CLP children.…”