Hearing Thresholds in Newborns with a Cleft Palate Assessed by Auditory Brain Stem Response

Objective: To objectively estimate the extent of hearing loss in infants with cleft palate and to measure the incidence of hearing loss. Design: Retrospective consecutive case note review. Setting: Tertiary institutional regional referral center for cleft lip and palate. Patients, Participants: Consecutive cases of 90 infants with cleft palate who underwent auditory brain stem response (ABR) threshold estimation. Interventions: ABR threshold estimation during natural sleep in infants with cleft palate under 2 months of age. Main Outcome Measures: Hearing level thresholds as estimated by auditory brain stem response and categorized as normal (< 25 ≤ 35 dB nHL), mild (> 35 ≤ 45 dB nHL), moderate (> 45 ≤ 65 dB nHL), severe (> 65 ≤ 90 dB nHL), and profound (> 90 dB nHL) hearing loss. Results: Hearing loss was present in 82% of the infants tested. Most of the hearing loss was conductive (89%), mild (86%), and bilateral (84%). Average age of ABR threshold estimation was 48.5 days. In 22% of infants there was an associated syndrome. The mean air conduction thresholds for the right and left ear were 40 and 39.7, respectively. Conclusion: The incidence of hearing loss in a cohort of cleft palate infants has been objectively estimated by auditory brain stem response thresholds and was found to be very high (82%).