There is a direct relationship between otitis media and cleft palate. Children with cleft palate have a much higher chance of developing otitis media than normal people because there is a passage called the eustachian tube from the middle ear inside the ear to the throat. The eustachian tube allows secretions from the middle ear to drain into the throat and maintains the pressure balance between the inner and outer sides of the eardrum. In patients with cleft palate, the palate is defective and the muscles of the soft palate are not normally distributed, which makes the opening and closing of the pharyngeal opening of the eustachian tube malfunction and creates negative pressure in the middle ear, so the problem of fluid accumulation in the middle ear (also known as exudative otitis media) often arises. According to statistics, fluid in the middle ear is a common complication in up to 95% of patients with cleft palate around 1 year of age. The main symptoms of fluid in the middle ear are hearing loss or a swollen feeling in the ear. However, since most young children do not indicate this, parents usually do not notice it. Unless the fluid becomes infected and becomes acute suppurative otitis media, there will be a fever or discharge from the ear canal. Sometimes, children may scratch their ears with their hands due to ear discomfort, so it is important to suspect that there is something wrong with the ear. If oozing otitis media is left untreated, the eardrum will scar and harden over time. If this is combined with frequent purulent otitis media, the damage to the eardrum will become even more severe, causing permanent hearing loss, which in turn will affect abnormal speech and voice development. Otolaryngologists can use an otoscope to examine the eardrum for abnormalities or perform a hearing test to see if there is a hearing impairment. In addition, a tympanogram can be performed to detect early middle ear pathology. Treatment is conservative or can be combined with a cleft palate repair in which a middle ear catheter is placed under general anesthesia to facilitate drainage of the plasma or mucus that accumulates in the middle ear cavity. It is advisable to avoid water in the ear canal after surgery to avoid purulent otitis media. The middle ear catheter will usually drain automatically from the eardrum within a year, but some people may experience a recurrence of middle ear fluid as a result and will need to be treated again.