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Newborn hearing screening in infants with cleft palates
Judy L Chen1, Anna H Messner, Ginny Curtin
1Department of Otolaryngology and Communication Enhancement, Children's Hospital, Boston, Massachusetts, USA.
Insights
Newborns with cleft palate have a higher risk of hearing loss. Persistent hearing loss after tympanostomy tubes may be linked to cleft palate alone, female sex, or associated syndromes.
Area of Science:
- Audiology
- Pediatric Otolaryngology
- Craniofacial Anomalies
Background:
- Conductive hearing loss from serous effusion is common in infants with cleft palate.
- Early detection of hearing impairment is crucial for speech and language development in this population.
Purpose of the Study:
- To investigate the outcomes of newborn hearing screening in infants diagnosed with cleft palate.
- To identify factors associated with persistent hearing loss in this cohort.
Main Methods:
- Retrospective cohort review of 114 newborns with cleft palate (1999-2005).
- Analysis of hearing screening results, tympanostomy tube placement outcomes, and audiograms.
- Collection of data on sex, gestational period, screening type, post-tube hearing loss, and associated syndromes.
Main Results:
- 72% of newborns with cleft palate passed their initial hearing screen.
- Among those who failed and received tympanostomy tubes, 43% had persistent hearing loss.
- Cleft palate alone, female sex, and associated syndromes predicted persistent hearing loss.
Conclusions:
- Newborns with cleft palate demonstrate an elevated risk of failing newborn hearing screening.
- Diagnosing hearing loss unrelated to middle ear effusions is challenging in cleft palate patients due to high rates of otitis media.
Objective:
The high incidence of conductive hearing loss from serous effusion in patients with cleft palate is well known. This study investigates the results and interpretation of newborn hearing screening in infants with cleft palates.
Study Design:
Retrospective cohort review.
Patients:
One hundred fourteen newborns with cleft palate, with or without cleft lip, born between 1999 and 2005 and referred to a craniofacial anomalies clinic.
Intervention:
Tympanostomy tubes were placed in 102 newborns, and follow-up audiograms were available for 104 infants.
Main Outcome Measures:
Hearing screening outcomes were collected. Sex, gestational period, type of screening performed, the presence of hearing loss after tube placement, and the presence of associated syndromes were noted.
Results:
Eighty-two (72%) of 114 of newborns with cleft palates passed their hearing screen. Of the 30 newborns who failed their hearing screen, and had tympanostomy tubes placed, 13 (43%) had persistent hearing loss after tube placement. Factors predicting persistent hearing loss include cleft palate alone, female infants, and the presence of an associated syndrome.
Conclusion:
Newborns with cleft palate are at higher risk of failing their newborn hearing screen compared with healthy neonates. Detection of sensorineural or conductive hearing loss unrelated to middle ear effusions is more difficult in this at-risk population with cleft palate because of the high prevalence of serous otitis media.
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