Frank F Yang1, Bradley McPherson, Huang Shu. 1. Division of Speech and Hearing Sciences, University of Hong Kong, 5F, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong, China. hkufrank@gmail.com
Abstract
OBJECTIVE: To objectively investigate the auditory status of mainland Chinese infants with nonsyndromic cleft lip and/or palate and to evaluate an auditory assessment protocol for this group. DESIGN: Prospective cohort case review. PATIENTS OR OTHER PARTICIPANTS: A total of 42 Chinese infants with nonsyndromic cleft lip and/or palate aged 6 to 24 months. INTERVENTION: The hearing profiles of participants were acquired using otoscopy, tympanometry, transient-evoked otoacoustic emissions, and auditory brainstem response estimated hearing threshold. The efficiency of the current audiological test battery was analyzed also. RESULTS: Sixty-four (64.2) percent of infants with nonsyndromic cleft lip and/or palate (55.9% of ears) were suspected to have middle ear disorder, and 85.7% of all subjects (83.3% of ears) were found to have hearing loss. Of those with confirmed loss, the overall mean auditory brainstem response estimated air-conduction hearing threshold was 53.5 ± 13.6 decibel normal hearing level [db nHL]. Using auditory brainstem response thresholds as a reference standard, the diagnostic agreement with the other assessment tools for normal/abnormal results was otoscopy, 69% (κ = .57); tympanometry, 66.7% (κ = .53); and transient-evoked otoacoustic emissions, 80% (κ = .64). CONCLUSION: The high prevalence of middle ear disease and hearing loss in mainland Chinese infants with nonsyndromic cleft lip and/or palate in this study was in contrast to previous studies of older age groups of Chinese children conducted in Hong Kong and Singapore. The audiological assessment protocol used in our study could provide useful information; although, modifications may be necessary to ensure a complete diagnostic overview for children with craniofacial clefts.
OBJECTIVE: To objectively investigate the auditory status of mainland Chinese infants with nonsyndromic cleft lip and/or palate and to evaluate an auditory assessment protocol for this group. DESIGN: Prospective cohort case review. PATIENTS OR OTHER PARTICIPANTS: A total of 42 Chinese infants with nonsyndromic cleft lip and/or palate aged 6 to 24 months. INTERVENTION: The hearing profiles of participants were acquired using otoscopy, tympanometry, transient-evoked otoacoustic emissions, and auditory brainstem response estimated hearing threshold. The efficiency of the current audiological test battery was analyzed also. RESULTS: Sixty-four (64.2) percent of infants with nonsyndromic cleft lip and/or palate (55.9% of ears) were suspected to have middle ear disorder, and 85.7% of all subjects (83.3% of ears) were found to have hearing loss. Of those with confirmed loss, the overall mean auditory brainstem response estimated air-conduction hearing threshold was 53.5 ± 13.6 decibel normal hearing level [db nHL]. Using auditory brainstem response thresholds as a reference standard, the diagnostic agreement with the other assessment tools for normal/abnormal results was otoscopy, 69% (κ = .57); tympanometry, 66.7% (κ = .53); and transient-evoked otoacoustic emissions, 80% (κ = .64). CONCLUSION: The high prevalence of middle ear disease and hearing loss in mainland Chinese infants with nonsyndromic cleft lip and/or palate in this study was in contrast to previous studies of older age groups of Chinese children conducted in Hong Kong and Singapore. The audiological assessment protocol used in our study could provide useful information; although, modifications may be necessary to ensure a complete diagnostic overview for children with craniofacial clefts.