Chen Judy L, Messner Anna H, Curtin Ginny
Department of Otolaryngology and Communication Enhancement, Children's Hospital, Boston, Massachusetts, USA.
Otol Neurotol. 2008 Sep;29(6):812-5. doi: 10.1097/MAO.0b013e318180a4e0.
The high incidence of conductive hearing loss from serous effusion in patients with cleft palate is well known. This study investigates the results and interpretation of newborn hearing screening in infants with cleft palates.
Retrospective cohort review.
One hundred fourteen newborns with cleft palate, with or without cleft lip, born between 1999 and 2005 and referred to a craniofacial anomalies clinic.
Tympanostomy tubes were placed in 102 newborns, and follow-up audiograms were available for 104 infants.
Hearing screening outcomes were collected. Sex, gestational period, type of screening performed, the presence of hearing loss after tube placement, and the presence of associated syndromes were noted.
Eighty-two (72%) of 114 of newborns with cleft palates passed their hearing screen. Of the 30 newborns who failed their hearing screen, and had tympanostomy tubes placed, 13 (43%) had persistent hearing loss after tube placement. Factors predicting persistent hearing loss include cleft palate alone, female infants, and the presence of an associated syndrome.
Newborns with cleft palate are at higher risk of failing their newborn hearing screen compared with healthy neonates. Detection of sensorineural or conductive hearing loss unrelated to middle ear effusions is more difficult in this at-risk population with cleft palate because of the high prevalence of serous otitis media.
腭裂患者因浆液性积液导致传导性听力损失的高发病率是众所周知的。本研究调查腭裂婴儿新生儿听力筛查的结果及解读。
回顾性队列研究。
1999年至2005年间出生并转诊至颅面畸形诊所的114例患有腭裂（伴或不伴唇裂）的新生儿。
102例新生儿置入了鼓膜造孔管，104例婴儿有随访听力图。
收集听力筛查结果。记录性别、孕周、所进行的筛查类型、置管后听力损失情况以及相关综合征的存在情况。
114例腭裂新生儿中有82例（72%）通过了听力筛查。在30例听力筛查未通过且置入了鼓膜造孔管的新生儿中，13例（43%）置管后仍存在持续性听力损失。预测持续性听力损失的因素包括单纯腭裂、女婴以及存在相关综合征。
与健康新生儿相比，腭裂新生儿听力筛查未通过的风险更高。由于浆液性中耳炎的高患病率，在这个腭裂高危人群中，检测与中耳积液无关的感音神经性或传导性听力损失更加困难。
