Optimal Management of Infants and Young Children with Conductive Hearing Loss associated with Cleft Palate

Ms Kylie Bolland1

 1Hutt Valley District Health Board, Lower Hutt, New Zealand


Management of children with conductive hearing loss is highly variable in terms of the age at which they may be fitted with a hearing instrument, and the instrument of choice. For example, babies identified as having a cleft palate or Down’s syndrome require close management to ensure appropriate access to sound for speech and language development, despite fluctuating hearing loss. The timing of surgical intervention varies and children can be left with sub-optimal aiding prior to surgical intervention taking place.

Conventional BTE hearing aids are not appropriate in these children due to the possible fluctuating nature of the conductive hearing loss component, and the outcome with different bone conduction devices is variable. Recently an audit was completed reviewing the hearing and speech and language outcomes for children born with cleft palate in the Wellington region.  Management of these children has been a focus at Hutt Hospital, with the introduction of a new protocol and testing regime to reveal the optimum fitting solution. The results will be discussed.

The study aims to review changes to the management strategies and compare the objective and subjective outcomes of the Ponto Bone Anchored Hearing Solution.

Review audit results of clinical findings and audiology management of babies with cleft palate in the Hutt Valley DHB area.  Describe how this audit formed the basis of a new protocol in use at Hutt Hospital for babies with cleft palate

Review of aided speech detection thresholds and speech in noise testing in children with Ponto devices

Results and conclusions:

Children performed well using the Ponto device. Implications for timely management and choice of device will be discussed and recommendations for management of conductive loss in this population group will be given


Kylie Bolland is a NZ trained Audiologist who has been the professional leader for Audiology at Hutt Hospital for the past 10yrs.  Prior to that Kylie worked as a paediatric Audiologist at the Nuffield Hearing and Speech Centre in London.