Imbery Terence E, Sobin Lindsay B, Commesso Emily, Koester Lindsey, Tatum Sherard A, Huang Danning, Wang Dongliang, Nicholas Brian D
1 Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University, Syracuse, New York, USA.
2 Department of Otolaryngology, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2017 Oct;157(4):676-682. doi: 10.1177/0194599817707514. Epub 2017 Jun 27.
Objective Describe longitudinal audiometric and otologic outcomes in patients with cleft palates. Study Design Case series with chart review. Setting Single academic medical center. Methods Charts of 564 patients with a diagnosis of cleft palate (59% syndromic etiology, 41% nonsyndromic) from 1998 to 2014 were reviewed. Patients without at least 1 audiometric follow-up were excluded from analysis. Patient demographics, surgeries, audiometric tests, and otologic data were recorded for 352 patients. Results Forty-five percent had isolated cleft palates, 34% had unilateral cleft lip and palate, and 21% had bilateral cleft lip and palate. Patients were followed for a mean of 50.3 months with a mean of 3.2 separate audiograms performed. Patients received a mean of 2.93 pressure equalization tubes. Increased number of pressure equalization tubes was not associated with incidence of cholesteatoma, which was identified in only 4 patients. Nine patients underwent eventual tympanoplasty with an 89% closure rate. Analysis of mean air-bone gap by cleft type did not reveal significant differences ( P = .08), but conductive losses and abnormal tympanometry persisted into teenage years. Conclusions Patients with cleft palates have eustachian tube dysfunction, which, in our cohort, resulted in persistent conductive hearing loss, highlighting the importance of long-term follow-up. Cholesteatoma incidence was low and not associated with number of tubes, which at our institution were placed prophylactically. Tympanoplasty was successful in those with persistent perforations.
目的 描述腭裂患者的纵向听力测定和耳科结局。研究设计 图表回顾性病例系列研究。研究地点 单一学术医疗中心。方法 回顾了1998年至2014年564例诊断为腭裂患者的病历（综合征病因占59%，非综合征病因占41%）。未进行至少1次听力随访的患者被排除在分析之外。记录了352例患者的人口统计学资料、手术情况、听力测试和耳科数据。结果 45%为单纯腭裂，34%为单侧唇腭裂，21%为双侧唇腭裂。患者平均随访50.3个月，平均进行3.2次独立听力图检查。患者平均接受2.93根压力平衡管。压力平衡管数量增加与胆脂瘤发生率无关，仅4例患者被诊断为胆脂瘤。9例患者最终接受了鼓室成形术，闭合率为89%。按腭裂类型分析平均气骨导差未发现显著差异（P = 0.08），但传导性听力损失和鼓室导抗图异常持续至青少年期。结论 腭裂患者存在咽鼓管功能障碍，在我们的队列中，这导致了持续性传导性听力损失，凸显了长期随访的重要性。胆脂瘤发生率较低，且与置管数量无关，在我们机构置管是预防性的。鼓室成形术对持续性穿孔患者成功。
