To investigate whether reported parental concern is supported by hearing assessment findings in children with cleft palate. To describe this population by examining the relationship between cleft type, middle ear status, and hearing loss.
Design:
Retrospective consecutive case note review.
Setting:
Tertiary institutional regional cleft center.
Patients:
Consecutive cases of 194 babies born with cleft palate and referred to the specialist center from January 2009 and December 2013. Following exclusions, data from 155 infants were included for analysis.
Interventions:
Documented parental concern in ear, nose and throat (ENT) and speech and language therapy case notes were compared to hearing assessment findings. Findings from otoscopic examination, tympanometry, and hearing assessment were analyzed with respect to cleft type.
Results:
Parental concern is not always accurately reflected by objective assessment particularly when no concern is reported. Analysis of the cohort examined suggests that cleft type is not related to middle ear findings or hearing.
Conclusions:
It is helpful to be aware of parental concern and clinicians should consider that parental reports may not be accurately reflected by test results. As cleft type was not found to substantially influence middle ear status or hearing it is not recommended to adapt speech and language advice offered to families according to cleft type. Follow-up studies to increase participant numbers would support a statistical analysis.
AhnJHKangWSKimJHKohKSYoonTH. Clinical manifestation and risk factors of children with cleft palate receiving repeated ventilating tube insertions for treatment of recurrent otitis media with effusion. Acta Otolaryngol. 2012;132(7):702–707.
2.
AlperCMLoseeJESerokyJTMandelEMRichertBCDoyleWJ. Resolution of otitis media with effusion in children with cleft palate followed through 5 years of age. Cleft Palate Craniofac J. 2016;53(5):607–613.
3.
ÇağlarÖBulbulFSennarogluL. Incidence of otitis media with effusion and long-term clinical findings in children with cleft lip and palate types. J Ear Nose Throat. 2013;23(5):268–274.
4.
ChandoSYoungCCraigJCGunasekeraHTongA. Parental views on otitis media: systematic review of qualitative studies. Eur J Pediatr. 2016;175(10):1295–1305.
5.
ChenYWChenKTChangPHSuJLHuangCCLeeTJ. Is otitis media with effusion almost always accompanying cleft palate in children? The experience of 319 Asian patients. Laryngoscope. 2012;122(1):220–224.
6.
ChuKMMcPhersonB. Audiological status of Chinese patients with cleft lip/palate. Cleft Palate Craniofac J. 2005;42(3):280–285.
7.
D’MelloJKumarS. Audiological findings in cleft palate patients attending speech camp. Indian J Med Res. 2007;125(6):777–782.
8.
DedhiaKKitskoDSaboDChiDH. Children with sensorineural hearing loss after passing the newborn hearing screen. JAMA Otolaryngol Head Neck Surg. 2013;139(2):119–123.
9.
DoyleWJCantekinEIBluestoneCD. Eustachian tube function in cleft palate children. Ann Otol Rhinol Laryngol.1980;89(3 pt 2):34–40.
10.
EngelJAnteunisLVolovicsAHendriksJMarresE. Predictive value of parent-reported symptoms in the assessment of otitis media with effusion during infancy. Scand J Prim Health Care. 2000;18(1):25–29.
11.
FergusonLRussellCWynneD. Audiologic guidelines in a cohort of patients with cleft palate-how can we compare?Cleft Palate Craniofac J. 2016;53(no. 4). Conference Abstract.
12.
FlynnTMöllerCJönssonRLohmanderA. The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts. Int J Pediatr Otorhinolaryngol. 2009;73(10):1441–1446.
13.
FlynnTPerssonCMöllerCLohmanderAMagnussonL. A longitudinal study of hearing and middle ear status of individuals with cleft palate with and without additional malformations/syndromes. Cleft Palate Craniofac J. 2014;51(5):94–101.
14.
HallAWillsAKMahmoudOSellDWaylenAGrewalSSandyJRNessAR. Centre-level variation in outcomes and treatment for otitis media with effusion and hearing loss and the association of hearing loss with developmental outcomes at ages 5 and 7 years in children with non-syndromic unilateral cleft lip and palate: The Cleft Care UK study. Part 2. Orthod Cranifac Res. 2017;20(suppl 2):8–18.
15.
Handzic-CukJCukVGluhinicMRisaviRStajner-KatusicS. Tympanometric findings in cleft palate patients: influence of age and cleft type. J Laryngol Otol. 2001;115(2):91–96.
16.
HarrisLCushingSLHubbardBFisherDPapsinBCJamesAL. Impact of cleft palate type on the incidence of acquired cholesteatoma. Int J Pediatr Otorhinolaryngol. 2013;77(5):695–698.
17.
ImberyTESobinLBCommessoEKoesterLTatumSAHuangDWangDNicholasBD. Long-term otologic and audiometric outcomes in patients with cleft palate. Otol Neurotol. 2017;157(4):676–682.
18.
KhanSYPaulRSenguptaARoyP. Clinical study of otological manifestations in cases of cleft palate. Indian J Otolaryngol Head Neck Surg. 2006;58(1):35–37.
19.
KwanWMAbdullahVJLiuKVanCACTongMC. Otitis media with effusion and hearing loss in Chinese children with cleft lip and palate. Cleft Palate Craniofac J. 2011;48(6):684–689.
20.
LauWLKoCHChengWW. Prevalence and parental awareness of hearing loss in children with Down syndrome. Chin Med J. 2015;128(8):1091–1095.
21.
LehtonenVLithoviusRHAutioTJSandorGKYlikontiolaLPHarilaVPesonenPKoskinenSAnttonenV. Middle ear findings and need for ventilation tubes among pediatric cleft lip and palate patients in northern Finland. J Craniomaxillofac Surg. 2016;44(4):460–464.
22.
LiWShangWYuAZhangXLiuYZhangQ. Incidence and natural history of middle ear disease in newborns and infants with cleft palate. J Clin Otorhinolaryngol Head Neck Surg. 2007;21(7):296–298.
23.
LithoviusRHLehtonenVAutioTJHarilaVAnttonenVSandorGKYlikontiolaLP. The association of cleft severity and cleft palate repair technique on hearing outcomes in children in northern Finland. J Craniomaxillofac Surg. 2015;43(9):1863–1867.
24.
LoPSTongMCWongEMVanCAC. Parental suspicion of hearing loss in children with otitis media with effusion. Eur J Pediatr. 2006;165(12):851–857.
25.
LohmanderAOlssonMFlynnT. Early consonant production in Swedish infants with and without unilateral cleft lip and palate and two-stage palatal repair. Cleft Palate Craniofac J. 2011;48(3):271–285.
26.
LuthraSSinghSNagarkarANMahajanJK. The role of audiological diagnostics in children with cleft lip & palate (CLP). Int J Pediatr Otorhinolaryngol. 2009;73(10):1365–1367.
27.
MollerP. Hearing, middle ear pressure and otopathology in a cleft palate population. Acta Otolaryngol. 1981;92(1):521–528.
28.
ParvingAChristensenB. Children younger than 4 years of age, referred to an audiological department. Int J Pediatr Otorhinolaryngol. 1992;23(5):161–170.
29.
SheahanPMillerISheahanJNEarleyMJBlayneyAW. Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. Int J Pediatr Otorhinolaryngol. 2003;67(7):785–793.
30.
SkuladottirHSivertsenAAssmusJRemmeARDahlenMVindenesH. Hearing outcomes in patients with cleft lip/palate. Cleft Palate Craniofac J. 2015;52(2):e23–e31.
31.
SundmanHFlynnTTengrothBLohmanderA. ABR thresholds in infants born with CLP and OME and infants with OME. Int J Pediatr Otorhinolaryngol. 2016;81:21–25.
32.
SzaboCLangevinKSchoemSMabryK. Treatment of persistent middle ear effusion in cleft palate patients. Int J Pediatr Otorhinolaryngol. 2010;74(8):874–877.
33.
TanakaSMahabirRJupiterDMenezesJ. Updating the epidemiology of cleft lip with or without cleft palate. Plast Reconstr Surg. 2012;129(3):511e–518e.
34.
TanakaSMahabirRJupiterDMenezesJ. Updating the epidemiology of isolated cleft palate. Plast Reconstr Surg. 2013;131(1):650e–652e.
35.
ThompsonMDThompsonG. Early identification of hearing loss: listen to parents. Clin Pediatr. 1991;30(2):77–80.
36.
TierneySO’BrienKHarmanNLSharmaRKMaddenCCalleryP. Otitis media with effusion: experiences of children with cleft palate and their parents. Cleft Palate Craniofac J. 2015;52(1):23–30.
37.
ViswanathanNVidlerMRichardB. Hearing thresholds in newborns with a cleft palate assessed by auditory brain stem response. Cleft Palate Craniofac J. 2008;45(2):
87–193.
38.
ZhengWSmithJDShiBLiYWangYLiSMengZZhengQ. The natural history of audiologic and tympanometric findings in patients with an unrepaired cleft palate. Cleft Palate Craniofac J. 2009;46(1):24–29.
39.
ZingadeNDSanjiRR. The prevalence of otological manifestations in children with cleft palate. Indian J Otolaryngol Head Neck Surg. 2009;61(3):218–222.
