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

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 clefs. 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 clef lip and/or palate. The prevalence of hearing disorders reported in western patients with clef lip and/or palate is generally higher than in the eastern countries. However, hearing loss is common in children with clef 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 clef cases. The prevalence of sensorineural hearing loss is relatively higher in syndromic clefs than nonsyndromic clefs. Assessments of hearing loss in children with clefs should include case history taking and a detailed audiometric evaluation, and should be performed by otolaryngology and audiology professionals. Surgical treatment, including closure of clefs and ventilation tube insertion, is reported to be effective in reducing conductive hearing loss but this remains controversial. Nonsurgical 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 clef lip and/or palate, and recommends the systematic study of central auditory processing in children with clef lip and/or palate.