Short-term Impact of Cleft Palate Repair on Hearing and Middle Ear Function in Infants
-
摘要:
目的 探讨单纯腭裂修复术对腭裂婴幼儿听力和中耳功能的短期影响。 方法 2013年1月至2014年11月在北京协和医院行手术治疗的先天性腭裂婴幼儿33例, 其中男22例, 女11例, 在腭裂修复术前、术后1~24个月对患儿进行畸变产物耳声发射(distortion product otoacoustic emission, DPOAE)、听性脑干反应(auditory brainstem response, ABR)和226 Hz鼓室声导抗图检测, 观察腭裂修复术后患儿听力和中耳功能的短期变化。 结果 33例(66耳)腭裂婴幼儿手术时平均年龄为17个月(8.5~25个月)。64耳接受术前DPOAE测试, 7耳(10.9%)通过; 56耳接受术后DPOAE测试, 19耳(33.9%)通过, 手术前后通过率比较差异具有统计学意义(P < 0.01);术前术后均接受DPOAE测试的54耳中, 16耳(29.6%)听力改善。63耳接受术前ABR检查, 其中Ⅴ波反应阈平均值为(43.73±13.65)dB nHL; 62耳接受术后ABR检查, 其中Ⅴ波反应阈平均值为(35.65±13.75)dB nHL, 手术前后反应阈值比较差异具有统计学意义(P < 0.01);术前术后均接受ABR检测的53耳中, 29耳(54.7%)术后V波反应阈降低, 听力改善。手术前后226 Hz鼓室声导抗图分型比较差异无统计学意义(P>0.05)。 结论 单纯腭裂修复术术后患儿短期听力得到改善, 但中耳功能改善不明显。 Abstract:Objective To study the short-term impact of cleft palate repair surgery on hearing and middle ear function in infants. Methods Thirty-three infants with cleft palate who received cleft palate repair surgery from January 2013 to November 2014 in Peking Union Medical College Hospital were included in this study, including 22 male infants and 11 female infants. They were examined using distortion product otoacoustic emission (DPOAE), auditory brainstem response (ABR), 226 Hz probe-tone tympanometry before surgery and 1-24 months after surgery. Results The mean age of the 33 infants (66 ears) at the time of surgery was 17 months (8.5-25 months). Sixty-four ears were examined with preoperative DPOAE, with 7 ears (10.9%) passed; postoperative DPOAE was performed in 56 ears, with 19 ears (33.9%) passed. The passing rate was significantly improved after operation (P < 0.01). In the 54 ears for which both preoperative and postoperative DPOAE were conducted, 16 ears (29.6%) showed improved hearing. Sixty-three ears were examined with preoperative ABR, showing a mean hearing threshold of (43.73±13.65)dB nHL; 62 ears were examined with postoperative ABR, showing a mean hearing threshold of (35.65±13.75)dB nHL, significantly improved compared with the preoperative threshold (P < 0.01). In the 53 ears which received both preoperative and postoperative ABR, 29 ears(54.7%) showed reduced hearing thresholds. There was no significant difference in 226 Hz probe-tone tympanometry between preoperative and postoperative examinations(P>0.05). Conclusion In infants with cleft palate, short-term hearing improvement may be observed after repair surgery, while middle ear function may show no obvious improvement. -
Key words:
- cleft palate repair /
- infants with cleft palate /
- audiology /
- otology
-
[1] Yang FF, McPherson B. Assessment and management of hearing loss in children with cleft lip and/or palate: a review[J]. Asian J Oral Maxillofac Surg, 2007, 19:77-88. doi: 10.1016/S0915-6992(07)80021-5 [2] Lehtonen V, Lithovius RH, Autio TJ, et al. Middle ear findings and need for ventilation tubes among pediatric cleft lip and palate patients in northern Finland[J]. J Craniomaxillofac Surg, 2014, 44:460-464. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=54323cdd52dfca689baef9329f73b606 [3] Kuo CL, Lien CF, Chu CH, et al. Otitis media with effusion in children with cleft lip and palate: A narrative review[J]. Int J Pediatr Otorhinolaryngol, 2013, 77:1403-1409. doi: 10.1016/j.ijporl.2013.07.015 [4] Carroll DJ, Padgitt NR, Liu M, et al. The effect of cleft palate repair technique on hearing outcomes in children[J]. Int J Pediatr Otorhinolaryngol, 2013, 77:1518-1522. doi: 10.1016/j.ijporl.2013.06.021 [5] Skuladottir H, Sivertsen A, Assmus J, et al. Hearing outcomes in patients with cleft Lip/Palate[J]. Cleft Palate Craniofac, 2015, 52: e23-e31. http://cn.bing.com/academic/profile?id=2088c4ef9b2678ff05d5a5b4299ab8d1&encoded=0&v=paper_preview&mkt=zh-cn [6] Viswanathan N, Vidler M, Richard B. Hearing thresholds in newborns with a cleft palate assessed by auditorybrain stem response[J]. Cleft Palate Craniofac, 2008, 45:187-192. doi: 10.1597/06-078.1 [7] Gould HJ. Hearing loss and cleft palate: the perspective of time[J]. Cleft Palate J, 1990, 27: 36-39. http://cn.bing.com/academic/profile?id=1808555ebb42d6a532ca9fe49a186875&encoded=0&v=paper_preview&mkt=zh-cn [8] Flynnt T, Lohmander A, Möller C, et al. A longitudinal study of hearing and middle ear status in adolescents with cleft lip and palate[J]. Laryngoscope, 2013, 123:1374-1380. doi: 10.1002/lary.23839 [9] Curtin G, Messner AH, Chang KW. Otorrhea in infants with tympanostomy tubes before and after surgical repair of a cleft palate[J]. Arch Otolaryngol Head Neck Surg, 2009, 135: 748-751. doi: 10.1001/archoto.2009.106 [10] Bluestone CD, Paradise JL, Beery QC, et al. Certain effects of cleft palate repair on eustachian tube function[J]. Cleft Palate J, 1972, 9:183-193. http://cn.bing.com/academic/profile?id=70ec5aac30e36f646fc6bfb192fce778&encoded=0&v=paper_preview&mkt=zh-cn [11] Alper CM, Losee JE, Mandel EM, et al. Pre- and post-palatoplasty Eustachian tube function in infants with cleft palate[J]. Int J Pediatr Otorhinolaryngol, 2012, 76:388-391. doi: 10.1016/j.ijporl.2011.12.017 [12] Huang MS, Lee ST, Rajendran K. A fresh cadaveric study of the paratubal muscles: implications for eustachian tube function in cleft palate[J]. Plast Reconstr Surg, 1997, 100: 833-842. doi: 10.1097/00006534-199709001-00003 [13] Barsoumian R, Kuehn DP, Moon JB, et al. An anatomic study of the tensor veli palatini and dilatator tubae muscles in relation to eustachian tube and velar function[J]. Cleft Palate Craniofac, 1998, 35:101-110. doi: 10.1597/1545-1569_1998_035_0101_aasott_2.3.co_2 [14] Schönmeyr B, Sadhu P. A review of the tensor veli palatine function and its relevance to palatoplasty[J]. J Plast Surg Hand Surg, 2014, 48:5-9. doi: 10.3109/2000656X.2013.793603 [15] Polzer I, Breitsprecher L, Winter K, et al. Videoendoscopic, speech and hearing in cleft palate children after levator-palatopharyngeus surgery according to Kriens[J]. J Craniomaxillofac Surg, 2006, 34S:52-56. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=ef0aa654df14ef4d01a77c0d10826eed
点击查看大图
计量
- 文章访问数: 252
- HTML全文浏览量: 58
- PDF下载量: 3
- 被引次数: 0