title: The high prevalence of otitis media with effusion in children with cleft lip and palate as compared to children without clefts.
abstract: OBJECTIVE
  Children with cleft lip and palate universally present with otitis media with effusion. This prevalence has not been systematically studied. The purpose of the present study was to examine and compare the prevalence of otitis media with effusion, hearing sensitivity, and audiometry method utilised for assessment in children with and without clefts.
  
  
  METHODS
  Two groups of children (children with unilateral cleft lip and palate, N=22, and children without clefts, N=20) were followed prospectively and longitudinally from 1 to 5 years of age. Data were collected at four points (1, 1.5, 3, and 5 years of age). Assessments at each of the four points included: (1) otomicroscopy, (2) tympanometry, and (3) hearing assessment.
  
  
  RESULTS
  Overall the children with unilateral cleft lip and palate demonstrated a significantly higher prevalence of otitis media with effusion (121 ears, 74.7%) than children without clefts (31 ears, 19.4%) (p<0.001). This higher prevalence was also significant at 1, 1.5, 3, and 5 years of age (p<0.001). Of those ears with otitis media with effusion, 83.1% of the ears exhibited a hearing loss (PTA >20 dB), with this loss more prevalent in the cleft group (89.7% UCLP and 70.0% non-cleft). The hearing loss was significantly more pronounced in the cleft (group 35.71 dB HL UCLP and 26.41 dB HL non-cleft group). Children with unilateral cleft lip and palate utilised a lower age-appropriate audiometry testing method than age-matched children with no cleft at 1, 1.5, and 3 years of age.
  
  
  CONCLUSIONS
  Children with unilateral cleft lip and palate present with a significantly higher prevalence of otitis media with effusion than children without cleft. Also, the hearing loss associated with otitis media with effusion is demonstrated in this study. Furthermore, the method of audiometry has been examined and children with unilateral cleft lip and palate had to be assessed with a lower level of method than children without cleft.
authors.affiliation: Division of Audiology, Institute for Neuroscience and Physiology, Sahlgrenska Academy with Gothenburg University, Box 452, SE 405 30 Gothenburg, Sweden. traci.flynn@neuro.gu.se
authors.forename: Traci
authors.initials: T
authors.lastname: Flynn
authors.forename: Claes
authors.initials: C
authors.lastname: Möller
authors.forename: Radoslava
authors.initials: R
authors.lastname: Jönsson
authors.forename: Anette
authors.initials: A
authors.lastname: Lohmander
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods; D017677:Age Distribution; D001299:Audiometry / Q000379:methods; D002675:Child, Preschool; D002971:Cleft Lip / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D002972:Cleft Palate / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome