腭帆提肌重建术修复腭裂时凿断翼钩对中耳功能影响

目的探讨腭帆提肌重建术修复腭裂时凿断翼钩对腭裂病人听力及中耳功能的影响。方法选取72例腭裂病人,随机分为2组。实验组42例,行腭裂修复术时凿断翼钩,解剖并重建腭帆提肌;对照组30例,解剖并重建腭帆提肌,但术中不凿断翼钩。术前及术后6个月两组均作声阻抗和脑干听觉诱发电位检查以判定疗效。结果两组病人术后听力及中耳功能均获得改善（t=3.38、2.18,P〈0.05;χ^2=61.46、51.42,P〈0.01）,实验组与对照组比较差异无显著性（P〉0.05）。结论腭帆提肌重建术修复腭裂有助于腭裂病人听力及中耳功能的改善,手术中凿断翼钩与否对术后听力及中耳功能的改善无显著影响,提示腭帆提肌重建在维持中耳功能中的作用占主导地位。

THE EFFECT OF PTERYGOID HAMULUS FRACTURE ON MIDDLE EAR FUNCTION IN LEVATOR MUSCLE OF PALATINE VELUM RECONSTRUCTION OF CLEFT PALATE ANAPLASTY

Objective To study the effect of levator muscle of palatine velum reconstruction, during which the hamulus pterygoideus was chiseled into disconnection, on middle ear function of patients with cleft palate combined with secretory otitis media. Methods Seventy-two patients with cleft palate combined with secretory otitis media were divided into two groups： experimental group （42） and control group （80）. In experimental group, the patients＇ hamulus pterygoideus were chiseled into disconnection. In control group, patients were operated with pterygoid hamulus fracture. The patients＇ levator muscle of palatine velum was reconstructed in both groups. Acoustic impedance and brainstem auditory evoked potential were tested six months before and after operation. Results The middle ear function in all the patients was improved （t= 3.38,2.18, P〈0.05;χ^2 = 61.46, 51.42,P〈0.01）, and there was no significant difference between the two groups （P〉0.05）. Conclusion Levator muscle of palatine velum reconstruction of cleft palate anaplasty is beneficial for the improvement of middle ear function of the cleft palate patients with secretory otitis media. However, there was no significant improvement of middle ear function in patients with or without pterygoid hamulus fracture.