The overall incidence of cholesteatoma in Iowa has been estimated to be 6.01/100,000 population, or less than 0.01%. However, in patients with cleft palate seen at the University of Iowa Cleft Palate Clinic between 1947 and 1968 and followed for at least 10 years, the risk of developing cholesteatoma was 9.2%. In order to determine whether this high risk of cholesteatoma is still valid, a comparable retrospective study was undertaken of 153 patients with cleft palate who were born between 1969 and 1977, were enrolled in the University of Iowa Cleft Palate Clinic within 1 year of birth, and were followed by the interdisciplinary team for a minimum of 10 consecutive years. Cholesteatoma occurred in four patients (2.6%), a substantial decrease in the risk of developing cholesteatoma in a well-defined and longitudinally followed population.
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