“…9 , 10 the main reason for this seems to be a failure in the Eustachian Tube opening, consequent to an abnormal insertion of the soft palate elevator and tensor muscles, causing Eustachian Tube obstruction and negative pressure in the middle ear 11 ; Eustachian tube incapacity in balancing positive and negative pressures, because of its reduced elasticity and consequent functional obstruction 12 ; abnormality in tube compliance13; tube patency–the property of the tube in opening up more than what is normal, allowing secretions to pass from the nasopharynx to the tympanic cavity 14 ; and facial skeleton abnormalities 15 have been suggested as contributing factors. Thus, a high occurrence of OME and hearing loss have been found in these children with labio-palatine fissure, even after palate repair, because despite soft palate tensor muscle improvement after this surgical procedure, it is hardly normalized, and the patient may still have constant otitis episodes 16 , 17 , 18 , 19 , 20 .…”