The contribution of brainstem electric response audiometry (BERA) to the evaluation and management of infants with cleft palate.

In the three-year period ending December 1986, 31 infants followed by the Cleft Palate Team of our institution were evaluated with BERA one or more times. Seventy-four percent presented auditory threshold elevation on initial examination; none was observed to resolve spontaneously in the first year of life. Myringotomy and tympanostomy tube insertion normalized auditory thresholds effectively in most children with serous otitis media. In a few cases, however, recovery required several months. BERA can assist the early detection of children with sensorineural hearing loss. It may also be valuable as an additional consideration in selecting treatment of serous otitis media in these children. Precise guidelines as to the ideal time to perform tympanostomy requires further substantiation of the effects of early hearing loss on speech and language development.