To describe and compare the middle ear status and hearing sensitivity in adolescence with isolated cleft palate plus additional malformations and/or syndromes with those with only an isolated cleft palate.
Design
Retrospective and longitudinal. Two groups of individuals with isolated cleft palate were compared.
Participants
A cohort of individuals born over 4 years in the western region of Sweden. The cohort was divided into one group with isolated cleft palate (n = 31; ICP) and one group with isolated cleft palate plus additional malformations and/or syndromes (n = 37; ICP+).
Methods
Middle ear status and hearing thresholds were collected from the medical records at 7, 10, 13, and 16 years of age, examined, and compared within and between groups over time.
Results
The ICP+ group demonstrated a significantly higher prevalence of abnormal middle ear status and elevated hearing thresholds as compared with the ICP group. As the individuals aged, the prevalence of abnormal middle ear status decreased. The hearing levels in both groups decreased in the low to middle frequencies as individuals aged; however, the hearing in the high frequencies did not.
Conclusions
Individuals with cleft palate need to be followed routinely for middle ear status and hearing thresholds to ensure optimal audiological rehabilitation, with particular attention to those with additional malformations and/or syndromes.
AhonenJ.E., McDermottJ.C.. Extended high-frequency hearing loss in children with cleft palate.Audiology.1984; 23: 467–476.
2.
American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics Subcommittee on Otitis Media With Effusion.Otitis media with effusion.Pediatrics.2004; 113: 1412–1429.
3.
ArnoldW.H., NohadaniN., KochK.H.. Morphology of the auditory tube and palatal muscles in a case of bilateral cleft palate.Cleft Palate Craniofac J.2005; 42: 197–201.
4.
BardachJ., MorrisH.L., OlinW.H., GrayS.D., JonesD.L., KellyK.M., ShawW.C., SembG.. Results of multidisciplinary management of bilateral cleft lip and palate at the Iowa Cleft Palate Center.Plast Reconstr Surg.1992; 89: 419–432.
5.
BassettA.S., ChowE.W., HustedJ., WeksbergR., CaluseriuO., WebbG.D., GatzoulisM.A.. Clinical features of 78 adults with 22q11 Deletion Syndrome.Am J Med Genet A.2005; 138: 307–313.
6.
BennettM.. The older cleft palate patient.Laryngoscope.1972; 82: 1217–1225.
7.
BroenP.A., MollerK.T., CarlstromJ., DoyleS.S., DeversM., KeenanK.M.. Comparison of the hearing histories of children with and without cleft palate.Cleft Palate Craniofac J.1996; 33(2): 127–133.
8.
CalzolariE., BianchiF., RubiniM., RitvanenA., NevilleA.J., GroupE.W.. Epidemiology of cleft palate in Europe: implications for genetic research.Cleft Palate Craniofac J.2004; 41: 244–249.
9.
ChetpakdeechitW., MohlinB., PerssonC., HagbergC.. Cleft extension and risks of other birth defects in children with isolated cleft palate.Acta Odontol Scand.2010; 68: 86–90.
10.
ColemanJ.R., SykesJ.M.. The embryology, classification, epidemiology, and genetics of facial clefting.Facial Plast Surg Clin North Am.2001; 9(1): 1–13.
11.
DigilioM.C., PacificoC., TieriL., MarinoB., GiannottiA., DallapiccolaB.. Audiological findings in patients with microdeletion 22q11 (di George/velocardiofacial syndrome).Br J Audio.1999; 33: 329–333.
12.
DyceO., McDonald-McGinnD., KirschnerR.E., ZackaiE., YoungK., JacobsI.N.. Otolaryngologic manifestations of the 22q11.2 deletion syndrome.Arch Otolaryngol Head Neck Surg.2002; 128: 1408–1412.
13.
FlynnT., LohmanderA., MollerC., MagnussonL.. A longitudinal study of hearing and middle ear status with cleft lip and palateLaryngoscope.2013; 123: 1374–1380.
14.
FlynnT., MollerC., JonssonR., LohmanderA.. The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts.Int J Pediatr Otorhinolaryngol.2009; 73: 1441–1446.
15.
FordL.C., SulprizioS.L., RasgonB.M.. Otolaryngological manifestations of velocardiofacial syndrome: a retrospective review of 35 patients.Laryngoscope.2000; 110(3 pt 1): 362–367.
16.
FriaT.J., ParadiseJ.L., SaboD.L., ElsterB.A.. Conductive hearing loss in infants and young children with cleft palate.J Pediatr.1987; 111: 84–87.
17.
GouldH.J.. Hearing loss and cleft palate: the perspective of time.Cleft Palate J.1990; 27: 36–39.
18.
HagbergC., LarsonO., MileradJ.. Incidence of cleft lip and palate and risks of additional malformations.Cleft Palate Craniofac J.1998; 35: 40–45.
19.
HandzicJ., BagatinM., SuboticR., CukV.. Hearing levels in Pierre Robin syndrome.Cleft Palate Craniofac J.1995; 32: 30–36.
20.
Handzic-CukJ., CukV., GluhinicM., RisaviR., Stajner-KatusicS.. Tympanometric findings in cleft palate patients: influence of age and cleft type.J Laryngol Otol.2001; 115: 91–96.
21.
Handzic-CukJ., CukV., RisaviR., KaticV., KatusicD., BagatinM., Stajner-KatusicS., GortanD.. Pierre Robin syndrome: characteristics of hearing loss, effect of age on hearing level and possibilities in therapy planning.J Laryngol Otol.1996a; 110: 830–835.
22.
Handzic-CukJ., CukV., RisaviR., KatusicD., Stajner-KatusicS.. Hearing levels and age in cleft palate patients.Int J Pediatr Otorhinolaryngol.1996b; 37: 227–242.
23.
HubbardT.W., ParadiseJ.L., McWilliamsB.J., ElsterB.A., TaylorF.H.. Consequences of unremitting middle-ear disease in early life: otologic, audiologic, and developmental findings in children with cleft palate.N Engl J Med.1985; 312: 1529–1534.
MatsuneS., SandoI., TakahashiH.. Abnormalities of lateral cartilaginous lamina and lumen of eustachian tube in cases of cleft palate.Ann Otol Rhinol Laryngol.1991; 100: 909–913.
26.
McDermottJ.C., FaustiS.A., FreyR.H.. Effects of middle-ear disease and cleft palate on high-frequency hearing in children.Audiology.1986; 25: 136–148.
27.
MileradJ., LarsonO., HagbergC., IdebergM.. Associated malformations in infants with cleft lip and palate: a prospective, population-based study.Pediatrics.1997; 100(2 pt 1): 180–186.
28.
MollerP.. Long-term otologic features of cleft palate patients.Arch Otolaryngol.1975; 101: 605–607.
29.
NunnD.R., DerkayC.S., DarrowD.H., MageeW., StrasnickB.. The effect of very early cleft palate closure on the need for ventilation tubes in the first years of life.Laryngoscope.1995; 105(9 pt 1): 905–908.
30.
OttI.O., IssingP.R.. Bilateral, mixed hearing loss with a predominant sensorineural component in Larsen's syndrome.J Laryngol Otol.2008; 122(3): e6.
31.
OvesenT., Blegvad-AndersenO.. Alterations in tympanic membrane appearance and middle ear function in 11-year-old children with complete unilateral cleft lip and palate compared with healthy age-matched subjects.Clin Otolaryngol Allied Sci.1992; 17: 203–207.
32.
RobsonA.K., BlanshardJ.D., JonesK., AlberyE.H., SmithI.M., MawA.R.. A conservative approach to the management of otitis media with effusion in cleft palate children.J Laryngol Otol.1992; 106: 788–792.
TharpeA.M., SladenD.P.. Causation of permanent unilateral and mild bilateral hearing loss in children.Trends Amplif.2008; 12: 17–25.
39.
TimmermansK., Vander PoortenV., DesloovereC., DebruyneF.. The middle ear of cleft palate patients in their early teens: a literature study and preliminary file study.B-ENT.2006; 2(suppl 4): 95–101.
40.
TolarovaM.M., CervenkaJ.. Classification and birth prevalence of orofacial clefts.Am J Med Genet.1998; 75: 126–137.
41.
van der BurgtI.. Noonan syndrome.Orphanet J Rare Dis.2007; 2: 4.
