Studies Concerning the Problem of Ear Diseases in Cleft Palate Children

Abstract

A correlation between cleft palate and loss of hearing has been known to exist since the last century (I, 3). Later, the frequent occurrence of hearing disturbances in cleft palate patients could be proved by statistics. The figures recorded range between 40 and 90%. Thus, it is all the more surprising that both the question of the age of onset of this complaint and its pathogenesis and the possibilities of diagnosing and treating it have remained unsettled to a large extent. Subsequent to the latest publications both by Stool and Randall (20) and by Sholehvar and associates (18) , these problems became of vital interest again. Therefore, at the suggestion of these authors, we con— ducted clinical, microscopical and audiometrical examinations of our patients. Following, the results obtained are discussed in detail. Materials and Methods Forty subjects were used; both ears of each patient were examined. Because of the various types of hearing tests, we decided to divide the patients into two groups. Group I includes infants under the age of two with unilateral and bilateral clefts of whom measurements of im— pedance were taken. Group II consists of children over two years of age; they were tested by puretone audiometry. An otologic evaluation of both groups was made prior to reconstructive surgery of the cleft palate. The most important part of the physical examinations were the observations of both the ear drums and the middle ear with a Zeiss binocular otoscope at magnifications of 6X, 10X, and 16X. As in the case of the surgical closure of the clefts, controls were also made in general anesthesia. In the expectation of fluid being present in the middle ear, a pinhole was first made into the eardrum. If fluid appeared, a Drs. Koch and Hartung are assistants, and Dr. Neveling is senior assistant, Department