Department of Otorhinolaryngology, San Paolo Hospital, University of Milan, Milan, Italy.
Department of Maxillo-Facial Surgery, Smile House, Regional Center for CLP, San Paolo Hospital, University of Milan, Milan, Italy.
Eur Arch Otorhinolaryngol. 2022 Sep;279(9):4335-4343. doi: 10.1007/s00405-021-07187-5. Epub 2021 Dec 2.
Otitis media with effusion (OME), recurrent acute otitis media and conductive hearing loss (CHL) are significantly prevalent in children with cleft palate (CP) and cleft lip and palate (CLP). Rapid Maxillary Expansion (RME) appears to have a positive effect also on middle ear disorders in these patients. The study aims to offer a prospective evaluation of RME effects in a group of patients with CP/CLP in terms of OME, CHL.
A prospective observational study was conducted. Thirty-four CP, CLP and submucosa cleft patients who received orthodontic indication to RME treatment for OME or conductive hearing loss in a tertiary institutional Care Unit of San Paolo Hospital, Milan (IT), were included. Twenty-two patients matched for age and with analogous inclusion criteria except for indication to RME treatment were enrolled in the control group. Clinical otolaryngological evaluation, pure tone audiometry and tympanogram were performed at the beginning of treatment (T0), at the end of the expansion (T1) and at 6-month follow-up (T2).
Air-bone gaps and tympanogram results at each time interval.
In the main group, RME allowed a statistically significant improvement of air-bone gaps (according to frequency, p < 0.001-0.089 T0 vs. T1 and < 0.001-0.044 T0 vs. T2, Friedman's test) and tympanometry results (p = 0.002 T0 vs. T1 and p < 0.001 T0 vs. T2, Friedman's test). Improvements were stable during follow-up and were significantly better in the main group than in the control group.
CHL and middle ear effusion improved significantly overtime during RME and after 6 months of follow-up.
分泌性中耳炎（OME）、复发性急性中耳炎和传导性听力损失（CHL）在腭裂（CP）和唇腭裂（CLP）患儿中非常常见。上颌快速扩张（RME）似乎对这些患者的中耳疾病也有积极的影响。本研究旨在对一组 CP/CLP 患者进行前瞻性评估，以评估 RME 治疗对 OME、CHL 的影响。
进行了一项前瞻性观察研究。34 例 CP、CLP 和黏膜下裂患者因 OME 或传导性听力损失而接受正畸 RME 治疗，这些患者均来自米兰 San Paolo 医院三级医疗机构的治疗单元。22 例患者年龄匹配且具有类似的纳入标准，但除外 RME 治疗的适应证，这些患者被纳入对照组。在治疗开始时（T0）、扩张结束时（T1）和 6 个月随访时（T2），对患者进行临床耳鼻喉科评估、纯音听阈测试和鼓室图检查。
各时间点的气骨间隙和鼓室图结果。
在主要组中，RME 可显著改善气骨间隙（按频率，p<0.001-0.089 T0 与 T1 和 p<0.001-0.044 T0 与 T2，Friedman 检验）和鼓室压图结果（p=0.002 T0 与 T1 和 p<0.001 T0 与 T2，Friedman 检验）。在随访期间，这些改善是稳定的，且主要组的改善明显优于对照组。
RME 治疗过程中及治疗后 6 个月时，CHL 和中耳积液均有显著改善。
