Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Otolaryngology-Head & Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA; Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104281. doi: 10.1016/j.amjoto.2024.104281. Epub 2024 Apr 3.
Recent studies have suggested that children with an isolated cleft lip (CL) are more likely to develop middle ear disease and eustachian tube dysfunction (ETD) compared to the general population. This may be related to abnormal palatal musculature or an undiagnosed submucosal cleft palate (SMCP). We aim to determine the prevalence of SMCP in patients with CL who exhibit ETD.
A retrospective chart review was performed for children with an isolated CL requiring tympanostomy tubes over a 20-year period at an academic tertiary care medical center. Demographic, clinical, and surgical data were collected.
Three hundred twelve patients had an isolated CL, and 29 (9.3 %) children required tympanostomy tubes. Of those, nine (31 %) were found to have a SMCP (7 males, 6 Caucasian). The average age at CL repair was 3.94 ± 1.03 months, and the average age at tympanostomy tube placement was 13.68 ± 13.8 months. All nine patients had chronic otitis media, with four having mild conductive hearing loss and three having moderate conductive hearing loss. The SMCP was diagnosed at the time of CL diagnosis (4), after CL diagnosis with the diagnosis of chronic otitis media/ETD (2) and after a diagnosis of chronic otitis media/ETD.
Middle ear disease or eustachian tube dysfunction in a patient with an isolated cleft lip should raise suspicion for an accompanying undiagnosed SMCP.
最近的研究表明，与普通人群相比，患有单纯唇裂（CL）的儿童更有可能患上中耳疾病和咽鼓管功能障碍（ETD）。这可能与腭部肌肉异常或未诊断的黏膜下腭裂（SMCP）有关。我们旨在确定在表现出 ETD 的 CL 患者中 SMCP 的患病率。
对过去 20 年在一家学术性三级护理医疗中心因 CL 而需要鼓室造口术的患儿进行了一项回顾性图表研究。收集了人口统计学、临床和手术数据。
312 例患儿有单纯 CL，29 例（9.3%）患儿需要行鼓室造口术。其中 9 例（31%）患儿存在 SMCP（7 例男性，6 例白人）。CL 修复的平均年龄为 3.94±1.03 个月，鼓室造口术的平均年龄为 13.68±13.8 个月。所有 9 例患儿均有慢性中耳炎，其中 4 例有轻度传导性听力损失，3 例有中度传导性听力损失。SMCP 在 CL 诊断时（4 例）、CL 诊断后伴有慢性中耳炎/ETD 时（2 例）和慢性中耳炎/ETD 诊断后（3 例）诊断。
患有单纯唇裂的患者出现中耳疾病或咽鼓管功能障碍时，应怀疑伴有未诊断的 SMCP。
