CC BY-NC-ND 4.0 · Indian J Plast Surg 2009; 42(S 01): S144-S148
DOI: 10.1055/s-0039-1699388
Review Article
Association of Plastic Surgeons of India

Problems of middle ear and hearing in cleft children

Ramesh Kumar Sharma
Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh-160 012, India
Vipul Nanda
Department of Plastic Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh-160 012, India
› Author Affiliations
Further Information

Publication History

Publication Date:
15 January 2020 (online)


The hearing loss in a cleft patient is a well known complication, but generally gets ignored. These children continue to have recurrent otitis media with effusion that affects the hearing abilities. Unfortunatley the middle ear function may not improve with palatoplasty. Cleft palate teams need to follow up all such children beginning at birth and going into adulthood, decades after a ‘successful’ palate repair. These patients should have careful otological and audiological surveillance with appropriate interventions whenever required. The review article discusses the current status of hearing management in patients with cleft palate.


  • 1 Teele DW, Klein JO, Rosner B. Epidemiology of otitis media during the first seven years of life in children in Greater Boston: A prospective cohort study. J Infect Dis 1989;160:83-94.
  • 2 Stool SE, Randall P. Unexpected ear disease in inafants with cleft palate. Cleft Palate J 1967;4:99-103.
  • 3 Dhillon RS. The middle ear in cleft palate children, pre and post palatal closure. J R Soc Med 1988;81:710-3.
  • 4 Lou CC, Loh KK, Kunaratanam N. Middle ear disease in cleft palate patients in Singapore. Ann Acad Singapore 1988;17: 372-4.
  • 5 Yabe R, Abe M, Swashima M. Otitis media with effusion in patients with cleft palate and congenital velopharyngeal insufficiency. Nippon Jibbinkoka Gakkai Kaiho 1989;92:1012-20.
  • 6 DMello J, Kumar S. Audiological findings in cleft patients attending speech camp. Ind J Med Res 2007;125:777-82.
  • 7 Gordon AS, Jean-Louis F, Morton RP. Late ear sequelae in cleft palate patients. Int J Pediatr Otorhinolaryngol 1988;15:149-56.
  • 8 Albert DM, Garrett J, Specker B, Ho M. The otologic significance of cleft palate in a Sri Lankan population. Cleft Palate J 1990;27:155-61.
  • 9 Masters FW, Bingham HG, Robinson DW. The prevention and treatment of hearing loss in the cleft palate child. Plast Reconstr Surg 1960;25:503-9.
  • 10 Kemaloglu YK, Kobayashi T, Nakijama T. Analysis of craniofacial skeleton in cleft children with otitis media with effusion. Int J Pediatr Otolaryngol 1999;47:57-69.
  • 11 Gopalkrishna A, Goleria KS, Raje A. Middle ear function in cleft palate. Br J Plast Surg 1984;37:558-65.
  • 12 Ramana YV, Nanda V, Biswas G, Chittoria R, Ghosh S, Sharma RK. Audiological profile in older children and adolescents with unrepaired cleft palate. Cleft Palate Craniofac J 2005;42:570-3.
  • 13 Zheng W, Smith JD, Shi B, Li U, Wang Y, Li S, Meng Z, et al. The natural history of audiologic and tympanometric findings in patients with unrepaired cleft palates. Cleft Palate Craniofac J 2009;46:24-9.
  • 14 Tuncbilek G, Ozgur F, Belgin E. Audioligic and tympanometric findings in children with cleft lip and palate. Cleft Palate Craniofac J 2003;40:304-9.
  • 15 Dayan JH, Smith D, Oliker A, Haring MA, Cutting CB. A virtual reality model of Eustachian tube dilation and clinical implications for cleft palate repair. Plast Reconstr Surg 2005;116:236-41.
  • 16 Smith LK, Gubbels SP, MacArthur CJ, Milczuk HK. The effect of palatoplasty method on frequency of ear tube placement. Arch Otolaryngol Head Neck Surg 2008;134:1085-9.
  • 17 HandzikOECuK J, Cuk V, Risavi R, Katusik D, Katusik SS. Hearing levels and age in cleft palate patients. Int J Pedia Otolaryngol 1996;37:227-42.
  • 18 Valtonen H, Deitz A, Qvarnbeg Y. Long term clinical audiological and radiological outcomes in palate cleft children treated with early tympanostomy for otitis media with effusion: a controlled prospective study. Laryngoscope 2005;115:1512-6.
  • 19 Sheahan P, Miller I, Sheahan JN, Earley MJ, Blaney AW. Incidence and outcome of middle ear disease in cleft lip and/or cleft palate. Int J Pediatr Otolaryngol 2003;67:785-93.
  • 20 Broen PA, Moller KT, Karlstorm J, Doyle SS, Devers M and Keenan KM. Comparision of hearing histories of children with and without cleft palate. Cleft Palate Craniofac J 1996;33: 127-33.
  • 21 Robinson PJ, Lodge H, Jones PM, Walker CC, Grant HR. The effect of cleft palate repair on otitis media with effusion. Plast Reconstr Surg 1992;89:640-5.
  • 22 Desai SN. Early cleft palate repair completed before the age of 16 weeks: observations on a personal series of 100 children. Br J Plast Surg 1983;36:300OE4.
  • 23 Phua YS, Salkeld LJ, de Chalain TM. Middle ear disease in children with cleft palate: protocols for management. Int J Paediatr Otolaryngol 2009;73:307-13.
  • 24 Goudy S, Lott D, Candy J, Smith RJ. Conductive hearing loss and otopathology in cleft palate patients. Otolaryngol Head Neck Surg 2006;134:946-8.