腭裂修复术对咽鼓管功能与中耳的影响

Study on the eustachian tube and on the problems of middle ears of the children with cleft palate

目的 :探讨不同年龄组腭裂患儿施行腭裂修复术对咽鼓管功能障碍与中耳疾病的影响。方法 :12 1例 2 4 2耳腭裂患儿 ,分为早期腭帆修复组 (手术时平均年龄为 3 2个月 )与延迟腭帆修复组 (手术时平均年龄为 15个月 ) ,在腭裂修复术前、术后一年进行耳镜、耳显微镜检查 ,鼓膜穿刺术和 (或 )鼓膜切开术。结果 :2组腭裂患儿手术修复术前 90 %以上的中耳有病理性渗出 ,但延迟手术组腭裂患儿的中耳渗出向粘稠化、感染化转变 ,2组患儿中耳渗出情况在腭裂修复术后一年明显好转。结论 :腭裂可导致中耳炎 ,应尽早作耳科相关检查 ,对病理性渗出的中耳 ,应置放鼓室平衡管 ,以消除负压和引流。早期实施的腭帆修复术 ,对咽鼓管及中耳功能的恢复有明显的改善。

Aim: To study the prevalence of the dysfunction of eustachian tube and otitis media with effusion in young children with cleft palate. Methods: 121 cleft palate cases, including 242 ears are divided, according to the time of surgical closure of soft cleft palate, into two groups: early operated group and delay operated group. All children underwent routine otoscopic, otomicroscopic examination of the ears and they were also performed tympanotomy before and 1 year after veloplasty. Results: A significantly ( P <0,01) greater prevalence of otitis media with effusion was found among delay operated CP children than early operated CP children before veloplasty, and more mucotympanon and otitis media suppurativa were also found in delay operated CP children. No statistical significance was found 1 year after operation. Conclusion: Dysfunction of Eustachian tube and otitis media are commonly present among the CP children, tympanotomy and pressure equalization tube should be performed as early as possible so as to avoid complications of the middle ears, early veloplasty should be adopted for a better rehabilitation.