Early treatment of the universal otitis media of infants with cleft palate.

In 138 infants with cleft palate, secretory or suppurative otitis media was a universal complication. Middle ear aeration was instituted by means of myringotomy, aspiration of middle ear liquid, and insertion of tympanostomy tubes, and this procedure was repeated whenever recurrence of middle ear effusion followed blockage or extrusion of the tubes. In infants with either complete or incomplete clefts of the palate, satisfactory middle ear status could usually be maintained. Otorrhea through tympanostomy tubes occurred frequently, but usually responded promptly to treatment. Palate repair resulted in sharp improvement in middle ear status. Early relief of middle ear effusion anti establishment and maintenance of middle ear aeration in infants with cleft palate may help maintain normal hearing acuity throughout infancy, with favorable implications for language and intellectual development, and may reduce the risk of permanent middle ear damage and hearing impairment. Further study is necessary to determine the long-term efficacy of this regimen.