A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate.

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.