Middle ear problems in children with cleft palate: A cross-sectional study

Abstract

Cleft lip and/or palate is the one of most common birth defects [1]. The incidence varies between 1 and 1.82 among 1000 new-borns, varying with geographic and ethnic background [2]. Cleft patients are generally divided into three main categories: those with a cleft palate [CP], a cleft lip [CL] and a cleft lip and palate [CLP], all of which can occur isolated or as part of a craniofacial syndrome [3]. Due to the orofacial cleft, multiple problems can arise with feeding, dental development, speech development, appearance and psychological wellbeing, making cleft children a vulnerable population that requires specialised care on these different levels [4]. Children with a cleft palate are prone to developing middle ear problems, especially otitis media with effusion [OME] [5]. The most important factor in the pathogenesis of otitis media is the anatomical malformation of the paratubal muscles, which compromise the strength of the tensor veli palatini muscle, causing repetitive failure to open the Eustachian tube and ventilate the middle ear cavity. [6]. As a result, middle ear pressure declines and local secretions accumulate leading to OME [7,8].