Otological Correlates of Cleft Palate

228 The most common otological consequence of cleft palate disease is otitis media with effusion, which is a topic of interest and subject to controversy. Recent investigations have revealed abnormalities of middle ear mucociliary transport (Sade, 1970) and abnormal degrees of goblet cell formation of the middle ear epithelial elements (Bak-Pederson, 1973; Shemada, 1972). Variations in histochemical and ultrastructural elements of the middle ear mucosa in patients with otitis media with effusion have also been observed (Lim, 1976; Lim and Birck, 1971; Liu, 1975; Palva, 1975). Otitis media with effusion is not a problem isolated to children with cleft palate disease. Next to simple upper respiratory infections, otitis media with effusion is the most common organic disease confronting the practicing pediatrician (Hoekelman, 1977; Mclnerney, 1978).