V A Longitudinal Study of Ear Disease and Hearing Loss in Patients with Cleft Lips and Palates

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Abstract
The purpose of this study was to evaluate the otologic and audiologic findings of individuals with cleft lips or cleft palates or both. Subjects with a cleft lip only were not found to have a significant otologic or audiologic deficit. However, individuals with clefts of the lip and palate or palate only were very similar in the frequency with which they had significant ear pathology and hearing loss. Approximately one-half of the latter 2 groups have a history of ear infection, and a similar number showed evidence of ear disease on examination. When hearing loss was present, it was predominantly conductive in type and usually occurred bilaterally. Only 1.58% of the individuals with a cleft palate with or without cleft lip had a hearing loss 30 db or greater in both ears. A considerable fluctuation in hearing levels was found as a function of age. Of the better ears tested at 6 to 6 years of age 28.57% showed a hearing loss of 15 db or greater, while only 9.71% showed such a loss when tested at 8 years of age or older. The worse ears showed similar improvements. Only 4.00% of individuals had a decrease in hearing levels in the better ear between the time first tested (4 to 6 years) and the time when tested for this study. Age of otologic and audiologic examination and the type of cleft appear to be 2 important variables to be considered before generalizations are made from group data. Otologic pathologies and hearing losses do appear to be reversible when individuals with cleft palates are afforded systematic otologic care from infancy until 8 to 10 years of age.

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