Ungkanont Kitirat, Boonyabut Panrasee, Komoltri Chulaluk, Tanphaichitr Archwin, Vathanophas Vannipa
1 Department of Otolaryngology, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
2 Office for Research and Development, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.
Cleft Palate Craniofac J. 2018 Apr;55(4):590-595. doi: 10.1177/1055665617730361. Epub 2017 Dec 14.
To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate.
Retrospective cohort study in the tertiary care center.
Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies.
Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes.
Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%).
Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.
研究泰国腭裂患儿中耳积液的发病率及治疗结果。
在三级医疗中心进行的回顾性队列研究。
1997年6月至2015年1月期间，95名腭裂患儿被转诊进行耳部评估。15名患儿（15.8%）伴有颅面综合征性异常。
中耳积液的累积发病率、置管率、置管持续时间、听力结果及置管并发症。
在整个研究过程中，每8至12周进行一次耳部检查。12个月龄内患儿中耳积液的累积发病率为53.7%，24个月龄内为81.1%。研究结束时，所有患者至少有1次中耳积液发作。88名患儿（92.6%）接受了腭裂修复术，腭裂修复术前、后中耳积液的发病率无显著差异。入组时平均听力水平为40.8±18.4dB。76名患者（80%）进行了置管。置管的中位时间为11.7个月。置管率为0.5/年。末次随访时平均听力水平为23.5±14dB。24例（31.6%）出现经导管耳漏。
中耳积液在泰国腭裂患儿中很常见。对中耳积液的监测和置管有助于获得良好的听力结果。
