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修复后的腭裂和通气管及其与儿童和成人胆脂瘤的关联。

Repaired cleft palate and ventilation tubes and their associations with cholesteatoma in children and adults.

作者信息

Reiter Rudolf, Haase Stephan, Brosch Sibylle

机构信息

Department of Otokaryngology Head and Neck Surgery, Secion of Phoniatrics and Pedaudiology, University of Ulm, Frauensteige 12, 89070 Ulm, Germany.

出版信息

Cleft Palate Craniofac J. 2009 Nov;46(6):598-602. doi: 10.1597/08-166.1. Epub 2009 May 16.

Abstract

OBJECTIVE

To determine the influence of ventilation tubes (VTs) on the formation of cholesteatoma and hearing in operated cleft palate patients with chronic ear problems.

DESIGN

Retrospective 72-month follow-up of 116 operated cleft palate patients.

PATIENTS AND INTERVENTIONS

Demographic data, clinical examination, and hearing were evaluated. The patients were divided according to age and type of cleft and subdivided in a subgroup with (VT+) or without ventilation tube (VT-).

MAIN OUTCOME MEASURES

The effect of ventilation tubes (VT) on the incidence of cholesteatoma formation and degree of hearing loss in operated cleft palate patients with chronic ear problems.

RESULTS

The overall incidence of cholesteatoma was 15.5% (VT+, 14.0%; VT-, 16.7%; not significant). Bilateral hearing loss of >20 dB remained in 14.0% of the VT+ patients and in 22.7% of the VT- patients (p < .05). Submucous cleft palate (SM CP) adults (n = 15) developed high rates of cholesteatoma and hearing loss of >20 dB (both 26.7%).

CONCLUSIONS

Tube insertion had no influence on the development of cholesteatoma. Adults with submucous cleft palate especially require periodic otologic evaluation because they have Eustachian tube-related otologic disease and hearing loss at a higher rate than expected.

摘要

目的

确定通气管(VT)对腭裂手术患者慢性耳部问题中胆脂瘤形成及听力的影响。

设计

对116例腭裂手术患者进行为期72个月的回顾性随访。

患者与干预措施

评估人口统计学数据、临床检查及听力情况。患者按年龄和腭裂类型分组,并进一步分为有通气管(VT+)或无通气管(VT-)的亚组。

主要观察指标

通气管(VT)对腭裂手术慢性耳部问题患者胆脂瘤形成发生率及听力损失程度的影响。

结果

胆脂瘤总体发生率为15.5%(VT+组为14.0%;VT-组为16.7%;无显著差异)。VT+组14.0%的患者及VT-组22.7%的患者仍存在大于20dB的双侧听力损失(p<0.05)。黏膜下腭裂(SM CP)成年患者(n=15)胆脂瘤发生率及大于20dB听力损失发生率均较高(均为26.7%)。

结论

置管对胆脂瘤的发生发展无影响。黏膜下腭裂成年患者尤其需要定期进行耳科评估,因为他们患咽鼓管相关耳科疾病及听力损失的发生率高于预期。

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