Newborn hearing screening in infants with cleft palates

Objective: The high incidence of conductive hearing loss from serous effusion in patients with cleft palate is well known. This study investigates the results and interpretation of newborn hearing screening in infants with cleft palates. Study Design: Retrospective cohort review. Patients: One hundred fourteen newborns with cleft palate, with or without cleft lip, born between 1999 and 2005 and referred to a craniofacial anomalies clinic. Intervention: Tympanostomy tubes were placed in 102 newborns, and follow-up audiograms were available for 104 infants. Main Outcome Measures: Hearing screening Outcomes were collected. Sex, gestational period, type of screening performed, the presence of hearing loss after tube placement, and the presence of associated syndromes were noted. Results: Eighty-two (72%) of 114 of newborns with cleft palates passed their hearing screen. Of the 30 newborns who failed their hearing screen, and had tympanostomy tubes placed, 13 (43%) had persistent hearing loss after tube placement. Factors predicting persistent hearing loss include cleft palate alone, female infants,. and the presence of an associated syndrome. Conclusion: Newborns with cleft palate are at higher risk of failing their newborn hearing screen compared with healthy neonates. Detection of sensorineural or conductive hearing loss unrelated to middle ear effusions is more difficult in this at risk population with cleft palate because of the high prevalence of serous otitis media.