Int J Med Health Sci. Oct 2015,Vol-4;Issue-4 462 International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Assessment of Eustachian tube function before and after cleft palate repair S V Dhanasekaran 1* , Mithun Eldhose Joyce, 2 Govind Krishnan 3 , Abilash K C 4 , Komathi Raja 5 1 Professor and Head, 2 Senior Resident, 3,4,5 Post Graduates, Department of ENT, VMKVMCH, Salem. ABSTRACT Background: The incidence of hearing loss is higher in children with cleft lip and/or cleft palate. The etiologic basis for middle ear pathology and hearing loss in patients with Cleft palate is considered to be Eustachian tube dysfunction due to functional obstruction. Aim: To assess the Eustachian tube function before and after cleft palate repair. Methodology: A longitudinal study was conducted in the department of Otorhinolaryngology, at Kirupananda Variyar Medical College during the period of October 2012 to October 2014. A total of 50 patients with cleft palate were examined. Tympanometric analysis was done to study subjects before and after cleft palate repair. The patients underwent surgery for cleft palate repair. The parametric variables measured before and after palatoplasty were analysed using paired ‘t’ test and for all non parametric variables Man -Whitney ‘U’ test was applied for analysis. Results: The compliance of middle ear, middle ear pressure and middle ear reflex showed a statistic ally significant improvement in both the ears after the surgical correction for cleft palate. After the cleft palate repair the tympanogram showed that the type A graph among the patients were increased and type B and C graph were decreased and this difference was found to be statistically significant (p<.05). Conclusion: An overall hearing profile for the children with cleft lip and palate should be conducted before 5 years and early intervention is recommended as hearing loss in childhood could affect speech and language development as well as scholastic performance. KEYWORDS: Eustachian tube, cleft palate, tympanometry. INTRODUCTION Cleft lip and palate is one of the most common congenital anomaly. It occurs during the first 12 weeks of gestation. It has a birth prevalence rate ranging from 1/1000 to 2.69/ 1000 amongst different parts of the world1].Basic pathophysiology which contributes to deafness in these children is eustachian tube dysfunction leading to impaired middle ear ventilation. The incidence of hearing loss is known to be higher in children with cleft lip and/or cleft palate. There is great concern towards the production of normal speech and the prevention of facial deformity and so considerable attention is paid towards the development of a competent velopharyngeal sphincter and normal facial development in these children. Unfortunately, attention is often not paid to the complication of hearing loss in these children. The occurrence of recurrent acute otitis media or otitis media with effusion has been reported to be higher in children with cleft palate[2,3]. The etiologic basis for middle ear pathology and hearing loss in patients with Cleft palate is considered to be Eustachian tube dysfunction due to functional obstruction, secondary to failure of the palatal muscles to assist in opening the Eustachian tube. Persistence of fluid in the middle ear, with an intact tympanic membrane, for a continuous period of three months or more is categorized as otitis media with effusion (OME)[4]. Certain individuals, such as those with cleft palate, are more likely to develop OME. The association between two has been well documented since Alt described the presence of otorrhoea in a child with cleft palate in 1879[5]. Paradise et al. deduced thatmiddle ear disease probably develops in all cleft palate patients[6]. However, more recent studies have confirmed this figure to be around 90%[7-9]. Furthermore, the retrospetive nature of most of these works introduces reservations on the observations made. Finally, Original article