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Volume 19, Number 2, June 2007

Assessment and Management of Hearing Loss in Children with Cleft Lip and/or Palate: a Review


Frank F Yang, Bradley McPherson
Centre for Communication Disorders, Cleft Lip/Palate Centre, University of Hong Kong/Prince Philip Dental Hospital, Hong Kong

Abstract
Hearing loss as a common comorbidity in children with cleft lip and/or palate has been well documented. Auditory impairment may contribute to abnormalities in speech, language and learning abilities, and other communicative disorders in children with oral clefts. The functional consequences of hearing loss in this group should not be underestimated. In this paper, the existing literature is reviewed with an emphasis on the prevalence, type, assessment, and management methods for hearing loss in children with cleft lip and/or palate. The prevalence of hearing disorders reported in western patients with cleft lip and/or palate is generally higher than in the eastern countries. However, hearing loss is common in children with cleft lip and/or palate of all ethnicities. Conductive hearing loss caused by middle ear disease is reported to occur frequently in syndromic and non-syndromic cleft cases. The prevalence of sensorineural hearing loss is relatively higher in syndromic clefts than non-syndromic clefts. Assessments of hearing loss in children with clefts should include case history taking and a detailed audiometric evaluation, and should be performed by otolaryngology and audiology professionals. Surgical treatment, including closure of clefts and ventilation tube insertion, is reported to be effective in reducing conductive hearing loss but this remains controversial. Non-surgical treatments for middle ear disease and hearing aids have also been suggested in recent studies. This review also highlights the possible role of central auditory processing disorder in the hearing loss of children with cleft lip and/or palate, and recommends the systematic study of central auditory processing in children with cleft lip and/or palate.

Key words: Cleft lip, Cleft palate, Case management, Hearing loss, Language development disorders

Asian J Oral Maxillofac Surg. 2007;19:77-88.

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