Conductive hearing loss and otopathology in cleft palate patients

Abstract

Objectives: To assess incidence of conductive hearing loss, ear pathology, and associated communicative disorders in cleft palate patients. Methods: Retrospective chart review of 100 patients all treated at a tertiary facility since birth. Results: The median patient age was 19 years old (range, 7–25) at last follow up. Girls comprised 35% of group. The median age of cleft palate repair was 16 months (range, 12–60). Median number of myringotomy tubes placed was 3 (range, 1–7). Conductive hearing loss(CHL) >20 db PTA was found in 25% of patients at last follow-up. Severity of CHL was mild in 75%, moderate in 21%, and severe in 4%. Middle ear surgery was performed on 13%. Cholesteatoma was identified in 6%. The mean age at resolution of CHL was 5 years (range, 3–19). Developmental learning disorders were identified in 8%. Speech difficulties requiring surgical treatment occurred in 27%. Risk factors associated with CHL at last follow-up included middle ear surgery ( P = 0.016), cholesteatoma ( P = 0.003), and increased number of myringotomy tubes ( P = 0.030). Associations between CHL and age at cleft repair, speech impairment, or learning disabilities were not found. Conclusions: Otopathology in cleft palate patients continues to be a problem despite close observation. Children requiring increased number of myringotomy tubes, middle ear surgery, and found to have cholesteatoma are at increased risk for long-standing CHL. The impact of hearing on speech and developmental learning also underscore the importance of close audiologic monitoring in cleft palate patients.