腭裂患儿咽鼓管功能障碍与中耳疾病的研究

目的 :探讨不同年龄组腭裂患儿咽鼓管功能障碍与中耳疾病的发病情况。方法 :对 121例腭裂患儿 ,242耳 ,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 ) ,在术前、术后 1年进行耳镜 ,耳显微镜检查和鼓膜穿刺术或鼓膜切开术。结果 :两组患儿均有 90 %以上的中耳有病理性渗出 ,但延迟手术组患儿的中耳渗出向粘稠化 ,感染化转变 ,两组患儿中耳渗出情况在术后 1年明显好转。结论 :腭裂患儿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 ,早期的腭帆修复术对咽鼓管及中耳功能的恢复有明显的改善。

Study on the Dysfunction of Eustachian Tube With the Problems of Middle Ears on the Children With Cleft Palate

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 were divided,according to the time of surgical closure of cleft palate,into two groups:early operated group and delay operated group.All children underwent routine otoscopic,otomicroscopic examination of the ears and 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.