Otitis media in the cleft palate patient

The patient with a soft-palate cleft is destined to have middle-ear disease secondary to an obstructive phenomena of the eustachian tube. To prevent the ultimate sequelae of chronic middle-ear disease, simultaneous repair of the soft palate and placement of tympanostomy tubes are indicated as soon as possible. The 'earliest' date for the infant is determined by the 'rule of tens': minimum weight of 10 pounds, white cell count no greater than 10,000/mL and hemoglobin of at least 10 g/dL, at ten weeks of age. When this principle is strictly adhered to, the child has an optimal chance for attaining normal auditory function and normal language development.