Evaluation of Otological Disease and Interventions in a Submucous Cleft Palate Cohort: Single Centre Retrospective Study

Objective This study aims to provide exploratory data on the otological disease burden in submucous cleft palate (SMCP) and evaluate the effect of ventilation tubes and (other otological) surgery on hearing loss. Methods SMCP patients treated at the Maastricht University Medical Centre (MUMC+) between January 1999 and December 2023, registered in a database of the MUMC+ and MosaKids Children’s Hospital, and national registry of the Dutch Association for Cleft Palate and Craniofacial Anomalies (NVSCA), were retrospectively reviewed. Outcome measures include (acute) otitis media with or without effusion (AOM/OME), ventilation tube placement ((non-)concurrent with cleft repair) and hearing loss defined as a High Fletcher Index (HFI)> 30 dB. Results 33 SMCP patients were included. Twenty-nine patients had a history of AOM/OME and 27 patients received ventilation tubes. Ventilation tube placement resulted in a significant improvement in hearing, with a decrease in the HFI for the left and right ear (6.6 dB vs 10.6 dB, p<0.001) at the first post-intervention evaluation. Linear mixed-effects models suggest cleft palate repair improves long-term hearing outcomes (>15 years). Conclusion SMCP patients show a high otological disease burden, with combined ventilation tube use and cleft repair showing a potential for long-term improved hearing.