Otological Challenges in Patients With Non-Syndromic Cleft Lip and Palate: A Systematic Review

Objectives: To identify the various otological challenges associated with non-syndromic orofacial clefts, how these problems affect quality of life of patients with orofacial clefts and find out the perspectives and current trends in the management of otological problems. Design: We conducted systematic searches for retrospective studies, cross-sectional studies, case-control studies, cohorts’ longitudinal studies and prospective controlled trials in Medline and Google scholar databases. Identified studies were retrieved and assessed for eligibility. Results: Thirty-five articles met all inclusion criteria and were selected for qualitative analysis. Twenty-one articles evaluated otological challenges associated with cleft lip and palate, 7 articles evaluated associated quality of life of patients with otological challenges and 9 articles evaluated management of otological challenges. Based on the results from this review, otological challenges including otitis media with effusion, conductive and sensorineural hearing loss are commonly associated with cleft. The result is a reduced quality of life due to their negative effects on intelligibility and eloquence of speech. They can however be managed by various palatoplasty procedures, rapid maxillary expansion, and use of various otological aids performed at an early age. Conclusion: The prevalence otological challenges in the cleft population are high and these issues require early management due to their possible effects on quality of life. Hence, there is need to incorporate ear care in the routine management of cleft lip and palate.