ENT & Grommets

An intergal part of a Cleft Team is an ENT surgeon.  In my layperson's language I will try and explain

Why?

In order for our hearing to function, our middle ear must be full of air which is maintained by a tube from the back of your mouth to the middle ear.  This is shut closed and opens when we swallow air.  However, it is controlled by the palate muscles so between between 70-80% of babies who are born with cleft palate will have a faulty tube.

In June we brought Ultan to see an ENT Specialist, Dr Hui Yau, to have Ultan's inner ears check for fluid i.e. "glue ear".  He was recommended by Ultan's cleft surgeon, Dr Lam, who said they were classmates and always worked together. In the first 6 months of Ultan's life he hadn't had an ear infection and I knew he responded to noise therefore he could hear but I didn't know how clearly.  You can imagine if your middle ear was filled with fluid it would be similar to us listening while under water.  We can hear but it is muffled and unclear.  Ironically it was only days later that Ultan had his first ear infection - his one and only ear infection - which ended up with a 2 night stay in hospital.

Treatment

To treat glue ear, a tiny incision is made in the inner ear and any fluid present is sucked out.  Grommets are placed to act for the tubes by draining out fluids.  These grommets are not permanent and will be pushed out by the body in 6 months or so.  This will hopefully give a chance for the tubes to mature and take over their job.  It is a small procedure and takes about 15 minutes.

Fact

Non cleft babies suffer from glue ear also.  The main reason for this is because the tube is often immature and needs a little assistance from grommets until it catches up and starts doing its job, which is usually within 2 years.

Audiologist

I decided to have an audiologist to test Ultan's hearing.  I questioned my decision in the days leading up to the surgery.  I knew Ultan could hear so what difference would it make if she came back and told us he had ???? percentage hearing loss.  I haven't got the results yet but she did tell us after the procedure that all was OK.

Ear Plugs

However, the good thing about having an audiologist present was she was able to take an impression of Ultan's ear and have custom made ear plugs made.

You see,  the conservative ENT - and maybe even the liberal ENT - would agree that a baby with a cleft palate should not go swimming for the first few years of life.  I don't agree. I think if a baby's ear needs to be protected you can do this by using ear plugs and the baby gets the enjoyment of the pool.  With Hong Kong's sub tropical climate, the pool plays a big part in our everyday life! Ultan has already been in the pool and loves it, as you can see, but we always had to make sure he did not get his ears wet.