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Updated: Aug 5, 2026

Endoscopic Cholesteatoma Surgery
Published on: January 19, 2022
The effect of palate repair on otitis media with effusion
P J Robinson1, S Lodge, B M Jones
1Department of Surgery, University College Hospital, London, England.
Insights
Otitis media with effusion is common in children with cleft palate. Early ventilation is recommended to improve hearing and manage middle ear issues in these patients.
Area of Science:
- Pediatric Otolaryngology
- Craniofacial Anomalies Research
- Audiology and Hearing Science
Background:
- Cleft palate is frequently linked to otitis media with effusion (OME).
- OME can significantly impact hearing and speech development in affected children.
- Understanding the persistence of OME in cleft palate patients is crucial for management.
Purpose of the Study:
- To determine the prevalence of OME in infants with cleft palate before surgical repair.
- To assess the middle ear status and OME persistence post-palate repair.
- To evaluate the influence of age at repair and cleft type on OME.
Main Methods:
- Prospective study of 150 children with cleft palate (aged 2-18 months).
- Myringotomy performed before palate repair to assess OME prevalence.
- Otoscopic and tympanometric follow-up assessments for 140 children up to 4 years of age.
Main Results:
- 92% prevalence of OME at myringotomy before palate repair.
- Minimal improvement in middle ear status observed after palate repair.
- OME persisted in 70% of children up to 4 years of age, irrespective of repair age or cleft type.
Conclusions:
- OME is highly prevalent and persistent in children with cleft palate.
- Current palate repair strategies show limited impact on middle ear status.
- Advocates for early routine unilateral ventilation to ensure adequate hearing while minimizing tube-related morbidity.
Abstract:
Cleft palate in children is very frequently associated with otitis media with effusion. In this prospective study of 150 cleft palate children aged between 2 and 18 months, the prevalence of otitis media with effusion at myringotomy before palate repair was 92 percent. Otoscopic and tympanometric follow-up assessments for 140 children indicate that there is minimal improvement in middle ear status after palate repair. The condition is persistent in 70 percent of children up to 4 years of age. Furthermore, there is no evidence that age at repair or type of cleft is influential. These findings have implications for otologic management of cleft palate children. Early routine unilateral ventilation to ensure adequate hearing but minimize the morbidity of ventilation tubes is advocated.

