Werker C L, van den Aardweg M T A, Coenraad S, Mink van der Molen A B, Breugem C C
Department of Plastic Surgery and Department of Otolaryngology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
Department of Plastic Surgery and Department of Otolaryngology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Lundlaan 6, 3584 EA, Utrecht, The Netherlands.
Int J Pediatr Otorhinolaryngol. 2018 Aug;111:47-53. doi: 10.1016/j.ijporl.2018.05.019. Epub 2018 May 19.
Adopted children with cleft lip and/or cleft palate form a diverse group of patients. Due to increased age at palatal repair, adopted children have a higher risk of velopharyngeal insuffiency and poor speech outcome. Delayed palate repair may also lead to longer lasting Eustachian tube dysfunction. Decreased function of the Eustachian tube causes otitis media with effusion and recurrent acute otitis media, which can lead to other middle ear problems and hearing loss.
One-hundred-and-thirty-two adopted children treated by the Cleft palate team in Wilhelmina Children's Hospital during January 1994 and December 2014 were included. Retrospectively, middle ear findings, the need for ventilation tube insertion and hearing during childhood were assessed. Findings were compared with 132 locally born children with cleft lip and/or cleft palate.
Adopted children had a mean age of 26.5 months old when they arrived in our country. After the age of two the total number of otitis media with effusion episodes and the need for ventilation tube placement did not significantly differ among adopted and non-adopted children. Adopted children had significantly more tympanic membrane perforations. Hearing threshold levels normalized with increasing age. Although within normal range, adopted children showed significantly higher pure tone averages than locally born children when they were eight to ten years old.
In general, adopted patients with cleft lip and/or cleft palate did not have more middle ear problems or ventilation tubes during childhood. However, theyhave more tympanic membrane perforations.
患有唇裂和/或腭裂的领养儿童构成了一个多样化的患者群体。由于腭裂修复年龄的增加，领养儿童发生腭咽功能不全和语音预后不良的风险更高。腭裂修复延迟也可能导致咽鼓管功能障碍持续时间更长。咽鼓管功能下降会导致分泌性中耳炎和复发性急性中耳炎，进而可能导致其他中耳问题和听力损失。
纳入1994年1月至2014年12月期间在威廉明娜儿童医院腭裂治疗团队接受治疗的132名领养儿童。回顾性评估中耳检查结果、童年时期插入通气管的必要性和听力情况。将结果与132名当地出生的唇裂和/或腭裂儿童进行比较。
领养儿童抵达我国时的平均年龄为26.5个月。两岁以后，领养儿童和非领养儿童的分泌性中耳炎发作总数和插入通气管的必要性没有显著差异。领养儿童的鼓膜穿孔明显更多。听力阈值水平随着年龄的增长而恢复正常。虽然在正常范围内，但领养儿童在8至10岁时的纯音平均值明显高于当地出生的儿童。
一般来说，患有唇裂和/或腭裂的领养儿童在童年时期没有更多的中耳问题或通气管需求。然而，他们有更多的鼓膜穿孔。
