Children with cleft lip and/or cleft palate—the most common birth defect in the United States—present unique audiologic challenges that include a high incidence of otitis media with effusion (OME). Recently, the MED-EL ADHEAR system has opened up new options for these patients. Five case studies are presented here showing how this new system represents an innovative, non-surgical therapeutic option for children who are born with cleft palate.