gms | German Medical Science

Introduction: Because of the frequency of the seromucous otitis media (SMOM) and the associated conductive hearing loss (CHL) cleft children require a special audiological support.

Material & Methods: Sixty cleft children (average age: 4 months; 29 ♂, 31 ♀), examined audiologically for the first time between 1997 and 2003, were followed up for average 37 months. It took place tympanometry, CEOAE, reflex audiometry (auropalpebral reflex) or behavioural audiometry (COR) and in few cases BERA. The patients were divided between a cleft palate (CP) and a cleft non-palate (CNP) group.

Results: Thirty-eight children belonged to the CP, 22 to the CNP. In the CP group 19 children (50%) had a SMOM at the first contact compared with one child (4,5%) in the CNP group. The observation period was shaped of strong dynamics concerning the otological findings. In the CP group grommet insertion (GI) was performed once in 16 pat. (42%) and several times in 13 pat. (34%). In two pat. (5%) paracentesis alone was sufficient and in 7 pat. (19%) no otological treatment was necessary. In comparison in the CNP group a GI was performed once in one pat. (5%) and several times in two pat. (9%), a paracentesis alone was performed in two pat. (9%). In seventeen pat. (77%) no treatment was necessary. At the end of the observation period 19 pat. (50%) of the CP group had a normacusis, 18 pat. (47%) had still a CHL and one pat. (3%) had a sensorineural hearing loss. In the CNP group 19 pat. (86%) had a normacusis and 3 pat. (14%) had still a CHL.

Conclusions: Because of the multiform process of the audiological findings with cleft children a regular audiological support is necessary. As expected children with cleft palate are significantly more frequently affected by the SMOM than children with exclusive cleft lip. The measurement of the CEOAE proved as particularly effective.