An otorhinological study of children with cleft palates

An otorhinological study of 245 children with cleft palate was carried out in two groups from two different hospitals. The incidences of deafness and exudative otitis media were much higher in the group where each child was seen by an otologist and hearing tested by audiogram. The lower incidence in the second group could be explained by the fact that a large number of children with exudative otitis media and deafness were missed as they were neither routinely seen by an otologist nor were they screened by audiograms. We found 37% of asymptomatic children were deaf. It is important therefore that all children with clefts of the palate should be seen by an otologist and investigated by audiogram and impedance test. The incidence of deafness was less if the cleft involved soft palate only and if the palate was repaired early. The incidence was also less in children who had their tonsils and adenoids removed. Infracture of the pterygoid hamulus during the repair of the soft palate failed to show any increase in the incidence of deafness. In this study we found a higher incidence of deafness amongst children with nasal escape. Fifty per cent of the children with clefts of the palate and lip had deviated nasal septum producing nasal obstruction.