鼓室置管治疗腭裂患者听力障碍的临床观察

目的　探讨伴分泌性中耳炎腭裂患者 ,采用鼓室置管术对中耳功能及听力损失的影响。方法　对 12 0例 ( 2 19耳 )患有分泌性中耳炎的腭裂患者 ,随机分为观察组 :腭裂修复 +鼓室置管术组 ;对照组 :单纯腭裂修复组。术后 6个月进行鼓室图 ,脑干听觉诱发电位检查。结果　中耳置管组术前术后V波反应阈值及轻中度听力损失有显著差异 (t =11 3 2 ,P <0 .0 1;χ2 =3 8 2 8,P <0 .0 0 1)。对照组术前术后V波反应阈值及轻中度听力损失均无显著差异 (t=1 2 4,P >0 .0 5 ;χ2 =2 46,P >0 .0 5 )。术前两组V波反应阈值及轻中度听力损失差异无显著性 (P>0 .0 5 ) ,术后两组V波反应阈值及轻中度听力损失差异有显著性 (t =12 86,P <0 .0 1;χ2 =10 12 ,P <0 .0 0 1)。中耳置管组术前术后鼓室图有显著差异 ( χ2 =40 75 ,P <0 .0 0 1) ;对照组术前术后鼓室图差异无显著性 ( χ2 =1 45 ,P >0 .0 5 )。术前两组鼓室图差异无显著性 ,术后两组鼓室图有显著差异 ( χ2 =2 0 76,P <0 .0 0 1)。结论　腭裂修复同时行鼓室置管有利于伴有分泌性中耳炎腭裂患者中耳功能改善 ,提高患者听力。

Clinical Observation on Pressure Equalization Tube into Tympanic Cavity in Therapy of Dysaudia of Patients with Cleft Palate

Objective To discuss the influence of pressure equalization tube into tympanic cavity on middle ear function and hearing loss of cleft palate patients with secretory otitis media.Methods 120 cleft palate patients (209 ears) with secretory otitis media were divided into observing group and control group at random. The patients of observing group accepted pressure equalization tube into tympanic cavity in addition to cleft palate anaplasty, while those of control group were simply given cleft palate anaplasty.All the patients were tested with tympanogram and brainstem auditory evoked potential (BAEP) 6 months later.Results In observing group,there were significant differences in both of V wave responsive threshold and slight-moderate hearing loss when compared between ante- and post operation ( t =11.32, P <0.01;χ 2=38.28, P <0.001),while no such differences were found in control group.No significant differences in V wave responsive threshold and slight moderate hearing loss existed between the two groups before operation, while such differences between the two groups appeared after operation ( t =12.86, P <0.01;χ 2=10.12, P <0.001).The tympanogram before operation clearly differed from that after operation in observing group (χ 2=10.12, P <0.001),and there was no such difference in control group.In observing group,postoperative tympanogram differed from that before operation (χ 2=40.75, P <0.001),while no such difference in tympanogram appeared. Clear postoperative difference in tympanogram was found between the two groups (χ 2=20.76, P <0.001),though such difference did not exist before operation.Conclusion Pressure equalization tube into tympanic cavity,in addition to cleft palate anaplasty,is helpful to the improvement of middle ear function of the patients with secretory otitis media and cleft palate.