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Skull Base Factors in Relation to Hearing Impairment in Cleft Palate Children

Objective: This investigation was performed to determine if an easily measurable, reproducible, bony parameter could be identified that might predict hearing loss in cleft palate children. Subjects: In this prospective study performed at the Sheffield Children’s Hospital (U.K.), 34 children with successfully repaired cleft palate who responded to a postal request for volunteers were assessed clinically, audiologically, and by lateral soft tissue neck radiography. Six children were excluded because of previous otologic surgery or poor quality radiographs. Twenty-six children who had the same series of investigations were randomly selected from routine otolaryngological outpatient clinics and acted as controls. Methods: The sphenopalatine angle (SPA), which relates the facial and cranial components of the skull, was measured on each child’s radiograph. Results: The median SPA in the cleft palate group was significantly greater than in the control group (p 5 0.01). In those cleft palate children with a hearing loss the sphenopalatine angle was smaller than in their normal hearing counterparts (p 5 0.01). No significant difference was found in the SPA between the hearing loss and normal hearing controls. There was no significant difference in age ranges between the hearing and hearing loss subgroups in each of the two primary groups. Conclusions: In this study, those cleft palate children with a smaller SPA have a greater incidence of hearing loss.