唇腭裂对低龄患儿听力影响的研究

Study of auditory status of infants with cleft lip and/or palate

目的:通过对2岁以下唇腭裂患儿进行术前耳科检查和听力测试,调查低龄唇腭裂患儿听力损伤的患病率。方法:选取2月-2岁唇腭裂患儿73例,分为单纯唇裂组、不完全腭裂组及完全腭裂组,术前进行耳镜检查、鼓室图、耳声发射(OAE)、听性脑干反应(ABR)等检查,并选择年龄相匹配的正常儿童61例作为对照组,进行组间比较。结果:单纯唇裂组、不完全腭裂组、完全腭裂组及正常对照组分别有18.2%、87.5%、96.3%、18.0%发生鼓膜异常,分别有9.1%、89.6%、96.3%、6.6%出现异常鼓室图,分别有34.1%、79.2%、98.1%、32.0%有OAE测试不通过,分别有6.8%、93.8%、98.1%、3.3%有ABR听阈异常。两个腭裂组在各项检查中的异常率均在统计学上显著高于单纯唇裂组和正常对照组,其中耳镜检查、鼓室图及ABR听阈检查两个腭裂组间无统计学差异。结论:低龄唇腭裂患儿听力损伤患病率较高,听力损伤与腭裂密切相关,但与腭裂类型无关。

Objective：To investigate the auditory status of infants with cleft lip and/or palate.Method：Seventy-three infants with cleft,aged from 2 to 24 months,were divided into 3 groups of cleft lip only,incomplete cleft palate and complete cleft palate.Sixty-one cases of normal children were selected as control group.All cases were examined using otoscopy,tympanometry,otoacoustic emissions（OAE）and auditory brain stem response（ABR）.The data were statistically compared between groups.Result：Of the four groups of cleft lip only,incomplete cleft palate,complete cleft and the control,the rates were 18.2 %,87.5 %,96.3 % and 18.0 % for abnormality,9.1 %,89.6 %,96.3 % and 6.6 % for abnormal tympanometry,34.1 %,79.2 %,98.1 % and 32.0 % being fail in OAE test,and 6.8 %,93.8 %,98.1 % and 3.3 % for abnormal ABR hearing threshold,respectively.The abnormal rates of two cleft palate groups in all examination methods are significantly higher than cleft lip group,while in tympanic membrane,tympanometry and ABR there is no statistical difference between the two cleft palate groups.Conclusion：High prevalence of hearing loss was observed in infants with cleft lip and/or palate.Hearing impairment is closely related with the existence of cleft palate,but not with the cleft palate type.