腭裂修复术同期中耳穿刺治疗分泌性中耳炎(附70例报告)

Palatoplasty and treatment of middle ear puncture in secretory otitis media simultaneously:a report of 70 cases

目的 探讨腭裂修复的同期行中耳穿刺对腭裂并发分泌性中耳炎 (SOM )听力的治疗作用。方法 腭裂修复前行声阻抗检查及听觉诱发电位检查。选择鼓室图为B型、声镫骨肌反射阴性、V波反应阈≥ 30dB(nHL)的患儿 70例 ,随机分为中耳穿刺组 4 6例 (76耳 )、常规组 2 4例 (48耳 )。按术后半年进行的声阻抗检查及脑干听觉诱发电位检查结果比较两组患儿的听力恢复情况。结果 中耳穿刺组手术前、后V波反应阈及鼓室图相比均有显著性差异 (P <0 .0 1) ,手术后中耳穿刺组与常规组V波反应阈均值及鼓室图均有显著性差异 (P <0 .0 1)。结论 腭裂并发分泌性中耳炎 ,修复腭裂的同期行中耳穿刺 ,听力恢复早而且效果好 ,中耳穿刺可防止粘连性中耳炎的发生。

Objective To study the influence of palatoplasty on the treatment of secretory otitis media by puncturing in the middle ear.Methods Acoustic impedance and auditory evoked potential were examined before palatoplasty.70 children with B type of tympanohyal drawing,negative vocal stapedial reflex and V wave reaction threshhold≥30dB were randomly divided into two groups:middle ear puncture group (46 cases 76 ears)and routine group(24 cases,48 ears).The results of examining acoustic impedance and brain stem auditory evoked potential half a year after operation were compared.Results There was a significant difference( P <0.01) in both V wave reaction threshhold and tympanohyal drawing in middle ear puncture group before and after operation.There was also a singnificant difference ( P <0.01) in both average value of V wave reaction threshhold and tympano hyal drawing in two groups after operation.Conclusions The patient with cleft palate complicated by secretory otitis media could reyain hearing earlier after receiving palatoplasty and middle ear puncture treatment of secretory otitis media simultaneously.The middle ear puncture could prevent adhesive otitis media from occurring.