How Does a Cleft Affect Hearing in Children?
Hearing problems are common in children with cleft palate. Here is what families should know.
Children born with cleft palate have a high rate of hearing problems, primarily due to Eustachian tube dysfunction.
- Why hearing is affected:
- The muscles that open and close the Eustachian tube are attached to the palate
- A cleft palate affects how these muscles work
- The Eustachian tube does not drain fluid from the middle ear
- Fluid builds up, causing middle ear infections (otitis media)
- Chronic fluid leads to conductive hearing loss
- How common is it?
- About 90% of children with cleft palate have middle ear fluid
- Most require ear tubes (tympanostomy tubes)
- Hearing loss is usually mild to moderate and conductive
- Types of hearing loss:
- Conductive β sound cannot reach the inner ear (most common, treatable)
- Sensorineural β the inner ear itself is affected (less common)
- Treatment:
- Ear tube placement (often done at the time of palate repair)
- Regular hearing tests (audiology)
- Hearing aids (if needed)
- BAHA (for children with microtia)
Monitoring
- Children with cleft palate should have:
- Newborn hearing screening
- Hearing test every 6β12 months
- Audiology evaluation as part of cleft team visits
Clinical Guidance
Hearing loss is very common in children with cleft palate due to Eustachian tube dysfunction. Ear tubes are frequently needed. Regular hearing monitoring and treatment ensure normal speech and language development.