**1. Introduction**

Cleft lip/palate (CLP) is a congenital orofacial anomaly that is debilitating for patients and psychologically stressful for family members. Children with CLP are forced to undergo a series of major invasive surgeries, including surgery for cleft lip repair, bone grafting, and dental implants [1].

Otitis media with effusion (OME), also called serous/secretory otitis media or glue ear, is a collection of nonpurulent fluid within the middle ear space. OME is a common condition among infants and children between the ages of 1 and 3 years [2]. Compared to healthy chil‐ dren, children with CLP are more susceptible to OME [3]. Despite the fact that the vast major‐ ity of patients (about 80%) do not have OME at birth [4], statistics show that OME occurs

at least once before the first birthday in as many as 90% of the infants born with CLP [2]. In addition, as many as 97% of the infants born with CLP suffer concurrent OME within the first two years of life [5].

The clinical significance of OME is often overlooked, and very few studies have explored this condition in depth, despite it being a complication commonly associated with CLP. This chapter reviews pathogenesis, clinical manifestations, consequences, examination, and diag‐ nosis related to OME in children with CLP. Controversies surrounding the treatment of OME in CLP children are also discussed. We also provide a flowchart for management guidance in OME in children with CLP. It is our hope that the results of this study will provide clinicians and patients/parents with a valuable reference.
