Middle ear function in cleft palate.

This study is based on an impedence audiometric evaluation of three groups of patients-20 with un-operated cleft palate, 28 normal subjects as controls and 20 operated cleft palate patients. Four major parameters have been analysed: middle ear pressure, static compliance, acoustic reflex and tympanometry. It was confirmed that in the normal child Eustachian tube function improves with growth and the critical age when the middle ear pressure becomes normal in almost all the normal children is 5 to 6 years. This process of improvement is disturbed in the presence of a cleft palate. Poor Eustachian tube function, evidenced by persistent negative middle ear pressure, continues to be commonly seen in the older subjects with un-operated cleft palates. The static compliance that reflects the elasticity of the conducting mechanism of the middle ear is poorer in cleft palate patients. It was also observed that when the cleft palate had been repaired before the age of 6 years, Eustachian tube function improved significantly in the older age group as shown by the lower incidence of negative middle ear pressure and Eustachian tube block. The high incidence of serous otitis media is apparently unaffected by surgery on the cleft palate and is responsible for some degree of hearing loss encountered in the older patients with operated cleft palates. Thus the incidence of hearing loss as studied by acoustic reflex is higher in all age groups in the presence of a cleft palate.