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Houston Cranio Facial

How Can a Cleft Palate Affect Hearing?

While a cleft lip alone doesn’t usually present a higher risk of long-term hearing loss when compared to children unaffected by a cleft deformity, individuals born with a cleft palate often face a number of unique challenges concerning their hearing and speech development. Hearing issues associated with a cleft palate can develop gradually and resolve on their own, only to arise again once more later in life. For this reason, it’s important to remain vigilant to potential hearing problems a child may experience growing up, and remain educated on the various ways that a facial cleft can hinder one’s hearing. In general, a cleft palate is commonly linked to the following auditory conditions:  

  • Increased risk of ear infections: Due to the irregular arrangement of muscles and tendons in children with a cleft palate, the deformity can lead to an increased risk of fluid buildup in the ear. Consequently, excess fluid buildup may lead to a higher risk of infection in the middle ear. Infections can cause rupture or perforation of the tympanic membrane or eardrum, as well as destruction of the middle ear tiny bones that transmit sound vibrations.  
  • Otitis Media with Effusion (OME), or “Glue Ear”: OME is typically characterized by a dysfunction in the eustachian tube, which balances air pressure between the middle ear and the back of the nose and throat. A cleft palate may prevent the eustachian tube from equalizing air pressure between these two regions. As a result, the ear may produce a thick liquid that impedes a child’s hearing. This happens because the three small bones in the middle ear — known as the Stapes, Incus, and Malleus — cannot vibrate normally due to the fluid, which prevents the sound transmission.
  • Conductive hearing loss: Conductive hearing loss occurs when sounds cannot penetrate the middle and/or outer ear, resulting in an inability to hear soft sounds. This type of hearing loss in children is sometimes associated with a cleft palate deformity. 

When Should a Hearing Test Be Performed?

If a child has a cleft palate with persistent hearing loss greater than six weeks, frequent ear infections, or chronic fluid in the middle ear, then an audiology exam needs to be performed. A Pediatric Otolaryngologist or Ear Nose and Throat (ENT) specialist who is part of our cleft team will be crucial in consultation about management of cleft palate hearing issues.

If your child was born with a cleft lip and/or cleft palate, craniofacial plastic surgeon Eric Payne, MD can create a plan of care to monitor potential concerns related to hearing, as well as to improve both cosmetic and functional issues stemming from a facial cleft. Our team of specialists can help determine the most ideal course of action in not only repairing a cleft lip and palate, but also providing a continuum of care for adult patients who previously had a facial cleft. 

Please contact The Craniofacial and Plastic Surgery Center in Houston for more information about cleft lip and palate treatment, or to schedule a consultation with Dr. Payne.