The Natural History of Audiologic and Tympanometric Findings in Patients with an Unrepaired Cleft Palate

Abstract

Objective: To present the tympanometric findings in 552 patients (115 over 10 years of age) with unrepaired cleft palate (256 had audiologic findings) and to show the natural history and outcome of these cases. Setting: The cleft lip and palate clinic for the Division of Cleft Lip and Palate Surgery at the West China College of Stomatology, Sichuan University, Chengdu, People's Republic of China. Design: Pure-tone audiometric and tympanometric evaluations were performed on 552 patients with an unrepaired cleft palate. Results were analyzed by looking at the patient's age and cleft palate type. Results: This study demonstrated an age-related decrease in the frequency of hearing impairment and abnormal tympanometry. The frequency of hearing impairment and abnormal tympanometry in patients with submucous cleft palate was significantly lower than in patients from the other four major cleft palate categories (p  =  .001, p  =  .006, respectively). Conclusions: The middle ear function and hearing levels of unrepaired cleft palate patients improved with age, but at least 30% of the patients’ ears demonstrated a hearing loss and abnormal tympanometry in each age group, including those over 19 years of age. In the crucial language-learning stage, the frequency of hearing impairment and abnormal tympanometry was as high as 60%. Considering these results, palate repair and surgical intervention, such as tube insertion, for otological problems should be considered at an early age.