The Nasal Airway and Hearing in Patients with Cleft Palate

Abstract

In a series of 63 cases of cleft palate or cleft lip and palate, the majority of which were repaired, tympanic membrane changes were encountered in 56 per cent and auditory impairment in 49 per cent. Narrowing of the nasal airway was demonstrated by an objective method in 45 per cent. The incidence of both aural pathology and nasal obstruction was significantly higher in the cases of cleft lip and palate than in those of palatine deformity only. The middle ear and nasal cavity changes appeared to be related. The narrowing of the nasal airway was caused by hyperplasia of the conchae, deviation of the septum or nasal aperture stenosis. Almost without exception, the latter two factors caused homolateral narrowing in cases of unilateral cleft lip and palate. Submucous septal resection and correction of deformed nasal alae, where needed, should be considered in patients with cleft lip and palate or cleft palate, whereas continued limitation of the use of adenoidectomy is recommended. The investigation emphasizes that the treatment of these deformities should include (1) a regular check on the condition of the ears from earliest infancy and consultation with an otologist whenever an ear affection is suspected, and (2) measures to improve the nasal airway if obstruction is present.