[The role of the otolaryngologist in the treatment of children with clefts].

Abstract

Cheilognathopalatoschises are a complex therapeutic problem not yet completely solved and demanding collaboration of a number of medical and paramedical branches. In a therapeutic team, an otorhinolaryngologist has an important role since he has to deal with impaired hearing, impaired nasal breathing, as well as with disturbed speech development. On the basis of an analysis of the state of hearing in children who were treated at the University Clinic for Otorhinolaryngology and Cervicofacial Surgery in Ljubljana, it was found that more than 76% of them suffered from hearing loss of different levels. Almost in all children with uni-or bilateral cheilognathopalatoschises nasal breathing was disturbed, due to deformities of alae and caudal border of septum. In all these children signs of chronic rhinitis were pronounced. A silent inflammation in the nose and in the epipharynx together with hyperplastic adenoids and disturbed function of the eustachian tube cause conduction hearing loss and recurrent otitis media, which hinders speech training. The authors are of the opinion that additional surgical interventions enabling nasal breathing and function of the middle ear should be implemented more frequently and sooner than up till now. All children with cleft-lip-palate should be permanently followed up by a group of subspecialized otorhinolaryngologists which would lead to a more successful and complete rehabilitation.