Hearing Loss in 5-Year-Old and 12-Year-Old Patients With a Cleft Palate and Evaluating Standardized Assessment Methods

This study describes the results of hearing assessment in patients with cleft palate with or without cleft lip (CP±L) enrolled in the International Consortium for Health Outcome Measures set for cleft lip and palate (ICHOM set). Other cleft initiatives were examined to provide an overview of the hearing assessment used. Data were analyzed from 390 patients with CP±L, aged 5 or 12 years, who were followed up according to the ICHOM set between 2016 and 2023. Statistical analysis evaluated pure-tone average (PTA) differences by age, cleft phenotype, sex, ventilation tube (VT) insertion, isolated CP±L, syndromes associated with hearing loss (HL), and syndromes with unknown associations with HL. Other cleft initiatives were reviewed to compare hearing assessments. The median PTA was higher in 5-year-olds (15.31 dB HL; IQR 10.0-27.5) than in 12-year-olds (10.0 dB HL; IQR 6.9-16.7; P <0.001). Patients with VT insertions had worse thresholds (median 12.50 dB HL; IQR 8.1-24.0) compared with those without (median 9.4 dB HL; IQR 5.8-13.8; P <0.001). Patients with syndromes associated with HL showed worse hearing thresholds (median 17.81 dB HL) than isolated CP±L (median 11.25 dB HL). Conductive hearing loss (CHL) was found in 35% of 5-year-olds and 15% of 12-year-olds. To improve the ICHOM set and align with other initiatives, assessments at additional frequencies (0.25-8 kHz), air and bone conduction, tympanometry, and evaluations around age 3 are recommended.