Hearing, middle ear pressure and otopathology in a cleft palate population

A population of 261 cleft-palate patients from western and northern Norway was evaluated by means of otoscopy, tympanometry and audiometry. Normal otoscopy was associated with middle ear pressure less negative than -150 mmH2O and with hearing better than 20 dB PTA. Flat tympanograms were found in 85% of cases with secretory otitis media. Secretory otitis media was dominant below the age of 3 years. Between 3 and 5 years of age changes in otoscopic and tympanometric findings were frequently observed. From 6 years of age a stable normalization took place. The close association between age and frequency of abnormal findings, makes age an important factor in the treatment of patients. A restricted use of ventilating tubes is advocated due to the possible occurrence of problems with otorrhea in infants and the possibility of provoking tympanosclerotic changes.