In a previous article,5 the audiologic results of this study were presented. It was reported that this population had mild to moderate conductive-type auditory impairment.
Although there has been no complete audiologic and otorhinologic evaluation of cleft-lip and cleft-palate cases prior to this study, the literature presents a number of ideas as to the basis of hearing loss in cleft-lip and cleft-palate persons. Generally, it is agreed that middle-ear pathology is the prime factor. However, there is less agreement as to the cause of the middle-ear pathology.
Openness of the palate, while discounted in one study,4 is considered a potent factor in that spread of upper respiratory infections through the Eustachian tubes to the middle ear is facilitated by the open palate.
Dysfunction of the Eustachian tube has been suggested as another potential threat to hearing.* Aside from the role of the Eustachian tube in harboring and