Optimal management of cleft lip and palate requires a multidisciplinary team approach to treatment, with the goal being maintenance of facial growth and improvement in speech and hearing, in addition to closure of the cleft. This can be especially challenging in a resource-poor setting where there is limited access to specialised personnel and expensive surgical tools and instruments. In such cases, ear management is often neglected due to need for audiology support and expensive perioperative equipment such as microscopes. The authors of this paper attempted to overcome this problem by using a low-cost pen-type endoscope intraoperatively to supplant an expensive operating microscope to assess the middle ear status of 91 patients undergoing cleft repair in a surgical camp organised in Sudan. Of the 182 ears assessed, 122 underwent myringotomy, with 44.26% of ears needing ventilation tube placement. Although the authors do not mention long-term results of this concurrent management, their innovative approach to making healthcare delivery more affordable in a resource-poor setting is commendable. This use of low-cost easily attainable technology may be applicable to the diagnosis and management of other ear conditions as well, potentially making specialist care available to a wider population in resource-poor regions of the world.