Kuo Chin-Lung, Lien Chiang-Feng, Chu Chia-Huei, Shiao An-Suey
Department of Otorhinolaryngology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan, ROC.
Int J Pediatr Otorhinolaryngol. 2013 Sep;77(9):1403-9. doi: 10.1016/j.ijporl.2013.07.015. Epub 2013 Aug 7.
Repair surgery of cleft lip and palate (CLP) can produce satisfactory cosmetic results but the problem of recurrent otitis media with effusion (OME) secondary to CLP may persist. This can cause long-term hearing loss and affect linguistic, academic, and personal development. The aim of this review is to provide the most recent information regarding OME in children with CLP.
All papers referring to children with CLP and OME were identified from searches in Medline, PubMed, Cochrane Library, and Web of Science. Abstracts were read and relevant papers were obtained. Additional studies were obtained from the references of the selected articles.
Both current and previous research on OME in children with CLP focused on the controversy over treatment strategies. Evidence on the optimal treatment for OME in CLP children was lacking. Ventilation tube surgery using the same anesthetic as lip or palate procedures was not well-supported. After summarizing the literature review, a flowchart of management guidance for such patients is also recommended. Updated reviews such as this will provide clinicians and patients/parents with a valuable reference.
The lack of evidence on the optimal treatment for OME in children with CLP should prompt a relatively conservative approach. However, only a consensus between patients/parents and surgeons regarding the most suitable treatment strategy for OME can ensure the greatest benefit to individual patients.
唇腭裂修复手术可产生令人满意的美容效果，但唇腭裂继发的复发性中耳积液（OME）问题可能持续存在。这可导致长期听力损失，并影响语言、学业和个人发展。本综述的目的是提供有关唇腭裂患儿中耳积液的最新信息。
通过检索Medline、PubMed、Cochrane图书馆和科学网，找出所有提及唇腭裂患儿和中耳积液的论文。阅读摘要并获取相关论文。从所选文章的参考文献中获取其他研究。
目前和以往关于唇腭裂患儿中耳积液的研究都集中在治疗策略的争议上。缺乏关于唇腭裂患儿中耳积液最佳治疗方法的证据。使用与唇或腭裂手术相同麻醉剂的通气管手术没有得到充分支持。在总结文献综述后，还推荐了此类患者的管理指导流程图。这样的更新综述将为临床医生和患者/家长提供有价值的参考。
唇腭裂患儿中耳积液最佳治疗方法缺乏证据，应促使采取相对保守的方法。然而，只有患者/家长与外科医生就中耳积液最合适的治疗策略达成共识，才能确保个体患者获得最大益处。
