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A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate
Traci Flynn1, Anette Lohmander, Claes Moller
1Department of Audiology, Sahlgrenska University Hospital, and Department of Audiology, University of Gothenburg, Gothenburg. traci.flynn@neuro.gu.se
Insights
Children with cleft palate experience decreasing middle ear issues with age, but high-frequency hearing loss persists, especially in the bilateral group. Regular audiological follow-up is crucial.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Craniofacial Anomalies
Background:
- Otitis media with effusion (OME) is common in children with cleft palate, potentially impacting hearing.
- Longitudinal data on OME prevalence and hearing sensitivity in this population is essential for effective management.
Purpose of the Study:
- To investigate the longitudinal prevalence of OME in children aged 7-16 based on cleft type.
- To assess changes in hearing sensitivity over time and across frequencies in children with cleft palate.
Main Methods:
- Retrospective longitudinal study of 58 children born 1991-1993 with cleft palate.
- Audiological and otological data reviewed at ages 7, 10, 13, and 16.
- Children categorized by cleft type: unilateral cleft lip and palate, cleft palate only, bilateral cleft lip and palate.
Main Results:
- Abnormal middle ear status prevalence significantly decreased with age.
- Isolated cleft palate group showed lower abnormal middle ear status prevalence (21%) compared to unilateral (32%) and bilateral (38%) groups at ages 7 and 16.
- Pure-tone average improved with age, but high-frequency pure-tone average did not; bilateral group had significantly poorer high-frequency hearing.
Conclusions:
- Children with cleft palate require consistent audiological and otological monitoring.
- Elevated high-frequency hearing thresholds may be linked to recurrent OME episodes in this cohort.
Objectives/Hypothesis:
To study longitudinal prevalence of otitis media with effusion (OME) in children between 7 and 16 years of age by cleft group, and hearing sensitivity across time and across frequencies.
Study Design:
Retrospective and longitudinal.
Methods:
All children with cleft palate born from 1991 to 1993 were included in the study (n = 58). Audiological and otological data were reviewed at 7, 10, 13, and 16 years of age. The group was divided by cleft type (24 unilateral cleft lip and palate, 23 cleft palate only, and 11 bilateral cleft lip and palate).
Results:
The prevalence of abnormal middle ear status decreased significantly with age. When comparing cleft types, the isolated cleft palate group presented with a significantly lower prevalence of abnormal middle ear status than the other groups at 7 and 16 years of age (21% as compared to 32% in the unilateral group and 38% in the bilateral group). The pure-tone average improved with age, while the high-frequency pure-tone average did not. When cleft types were compared, the bilateral group demonstrated significantly poorer hearing in the high frequencies than the other groups.
Conclusion:
Children with cleft palate need regular audiological and otological follow-up to ensure management is appropriate and timely. The increased hearing thresholds in the high frequencies may be due to the increased episodes of OME.
