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腭裂修复术后幼儿的咽鼓管功能

Postpalatoplasty Eustachian tube function in young children with cleft palate.

作者信息

Alper Cuneyt M, Losee Joseph E, Mandel Ellen M, Seroky James T, Swarts J Douglas, Doyle William J

机构信息

Department of Plastic Surgery, Children's Hospital of Pittsburgh of UPMC, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.

出版信息

Cleft Palate Craniofac J. 2012 Jul;49(4):504-7. doi: 10.1597/11-065. Epub 2011 Jul 8.

Abstract

OBJECTIVE

To characterize Eustachian tube function using the forced response test in young children with cleft palate with or without cleft lip after palatoplasty with tympanostomy tubes inserted prepalatoplasty and compare these results with those of a 1986 study that evaluated a similar population using identical methods.

SETTING

Outpatient research clinic.

PATIENTS/PARTICIPANTS: A total of 34 children with cleft palate were tested at an average age of 18.6 ± 4.0 months. MAIN OUTCOME MEASUREs: Passive and active measures for the forced response test.

RESULTS

Of the sample, 13 ears could not be tested, and tests on 24 ears were incomplete. The forced response test showed that the passive Eustachian tube function parameters were similar to those of normal adults and children. The percentage of ears that showed tubal dilation with swallowing was 60%. The active resistance and dilatory efficiency were similar to those of a normal adult population.

CONCLUSIONS

A 1986 study of Eustachian tube function in postpalatoplasty subjects with cleft palate (37 ears) aged 15 to 26 months documented Eustachian tube dilation with swallowing in 84% of the ears. In the present study, which focused on a similar population, the frequency of tubal dilation was 60%. Nonetheless, both frequencies are significantly greater than the dilation frequency of 27% reported for 56 ears of subjects with cleft palate tested between 3 months and 18 years with tympanostomy tubes inserted for persistent otitis media with effusion. This suggests that dilation during the forced response test may be a prognostic marker for those children with cleft palate who will resolve their ear disease at an early age.

摘要

目的

通过强制反应测试来描述腭裂患儿(无论有无唇裂)在腭裂修复术前插入鼓膜置管后的咽鼓管功能,并将这些结果与1986年一项使用相同方法评估类似人群的研究结果进行比较。

地点

门诊研究诊所。

患者/参与者:共对34名腭裂患儿进行了测试,平均年龄为18.6±4.0个月。主要观察指标:强制反应测试的被动和主动测量指标。

结果

样本中,13只耳朵无法进行测试,24只耳朵的测试不完整。强制反应测试表明,咽鼓管被动功能参数与正常成人和儿童相似。吞咽时出现咽鼓管扩张的耳朵百分比为60%。主动阻力和扩张效率与正常成人人群相似。

结论

1986年一项对15至26个月大的腭裂修复术后受试者(37只耳朵)的咽鼓管功能研究记录了84%的耳朵在吞咽时出现咽鼓管扩张。在本研究中,针对类似人群,咽鼓管扩张的频率为60%。尽管如此,这两个频率均显著高于因持续性中耳积液而插入鼓膜置管的3至18岁腭裂受试者56只耳朵报告的27%的扩张频率。这表明,强制反应测试期间的扩张可能是那些腭裂患儿早期耳部疾病得以解决的一个预后指标。

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