Current concepts of treatment of ear disease in cleft palate children and adults.

This author had demonstrated that the incidence of conductive hearing loss in adults who have had cleft palates approximates 50%. That their ear disease arises during infancy has been well documented by Stool and Paradise. The serous otitis media which develops in infancy and persists through adolescence is presently best treated by tympanic aeration tubes. Whether or not a limited adenoidectomy is a useful adjunct in treatment remains to be conclusively demonstrated. That cleft palate repair and/or pharyngeal flap surgery is helpful in the eventual outcome of ear disease would seem to be so. The end product of recurrent serous effusions and/or ear infections can be a chronic draining ear and/or cholesteatoma which following the attainment of adolescence is best treated by mastoid tympanoplasty with ossicular reconstruction. The effect of hearing on the speech of palate patients is discussed and a new method for using visual cues in helping palate patients speak less hypernasally offered.