Hearing Thresholds in Young Children With Otitis Media With Effusion With and Without Cleft Palate
Birgitta Tengroth1,2, Anette Lohmander2, Christina Hederstierna1,2
1Department of Hearing and Balance, Karolinska University Hospital, Stockholm, Sweden.
Insights
Children with cleft palate (CP±L) and otitis media with effusion (OME) have similar hearing thresholds. However, CP±L cases showed better hearing at 12 months, with both groups improving over time.
Area of Science:
- Pediatric audiology
- Otolaryngology
- Developmental pediatrics
Background:
- Children with cleft palate (CP±L) and otitis media with effusion (OME) are at risk for hearing impairment.
- Understanding hearing development in these populations is crucial for early intervention.
Purpose of the Study:
- To compare hearing thresholds in children with CP±L and age-matched children with OME but without cleft.
- To track hearing development longitudinally from infancy to 36 months.
Main Methods:
- A prospective longitudinal group comparison study was conducted.
- Hearing was assessed using neonatal auditory brainstem response (ABR) and age-appropriate tests up to 36 months.
- Participants included 16 children with CP±L and 15 children with OME without cleft.
Main Results:
- Both groups showed elevated neonatal ABR thresholds, with no significant initial difference.
- At 12 months, children with CP±L had significantly better hearing thresholds (4-frequency average) than the OME-only group (P < .01).
- Hearing improved over time in both groups, with normal thresholds by 36 months.
Conclusions:
- Hearing loss severity in children with CP±L is comparable to, and at 12 months better than, that in children with OME alone.
- Air conduction thresholds demonstrate age-related improvement in both cohorts.
Objective:
To investigate hearing thresholds in children born with cleft palate and in children with otitis media with effusion but no cleft palate.
Design:
Prospective longitudinal group comparison study.
Setting:
University hospital.
Participants:
Sixteen children born with nonsyndromic cleft palate with or without cleft lip (CP±L) and 15 age-matched children with otitis media with effusion (OME) but without cleft.
Main Outcome Measures:
Hearing was tested at repeated occasions beginning with neonatal auditory brainstem response (ABR) at 1-4 months of age, and age-appropriate hearing tests from 9 to 36 months of age.
Results:
The median ABR thresholds in both groups were elevated but did not differ significantly. At 12 months of age, the median 4 frequency averages at 500-1000-2000-4000 Hz (4FA) were indicative of mild hearing loss but significantly better in the CP±L-group than in the group without cleft (P < .01). There were no significant group-wise differences regarding the median 4FA at 24 and 36 months of age, and at 36 months, the median 4FA were normal in both groups. Both groups exhibited a significant improvement over time from the neonatal ABR thresholds to the 4FA at 36 months (CP±L-group P < .05; without CP±L-group P < .01).
Conclusion:
The hearing loss in children with CP±L was not more severe than among children with OME but without cleft palate; rather, at 12 months of age, the thresholds were significantly better in the CP±L-group than those in the group without cleft. The air conduction thresholds improved with age in both groups.
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