Mathew P C, Goyal Manoj, Mittal Neeti
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Santhosh Deemed to be University, Ghaziabad, Uttar Pradesh, India.
Ann Maxillofac Surg. 2024 Jan-Jun;14(1):5-9. doi: 10.4103/ams.ams_185_23. Epub 2024 Apr 3.
Cleft palate, a common congenital craniofacial defect, requires surgical repair and many surgical approaches have been employed for the same to reduce the risk of post-operative complications and improve outcomes. In order to achieve tension free closure, fracture of pterygoid hamulus has been advised. However, the effect of this manoeuvre on auditory functions remains debatable. The study was designed to evaluate the effect of hamulectomy on auditory function during the post-operative period after palatoplasty.
The present study enrolled 100 participants aged 10 months-2 years with isolated cleft palate defect. They were randomly divided into two groups: palatoplasty with hamulectomy ( = 50) and palatoplasty without hamulectomy ( = 50). Hearing outcomes were evaluated using objective measures (otoscopy, tympanometry, and otoacoustic emission [OAE] tests) at 1-month and 6-month post-operative follow-up visits. The Chi-square test was used to analyse the data and significance level was kept at ≤ 0.05.
The findings of otoscopy, tympanometry and OAE tests were statistically similar between the two study groups ( > 0.05; Chi-square test) at both one month and six months follow-up visits. Another noteworthy observation was improvement in auditory function during follow-up period indicating recovery of middle ear function following palatoplasty.
The addition of hamulectomy to the palatoplasty treatment may improve the hearing outcomes for cleft palate patients and can be adopted to achieve tension free closure.
腭裂是一种常见的先天性颅面缺陷,需要进行手术修复,并且已经采用了多种手术方法来降低术后并发症的风险并改善治疗效果。为了实现无张力缝合,有人建议折断翼钩。然而,这种操作对听觉功能的影响仍存在争议。本研究旨在评估腭裂修复术后翼钩切除术对听觉功能的影响。
本研究纳入了100名年龄在10个月至2岁之间的单纯腭裂患儿。他们被随机分为两组:腭裂修复术联合翼钩切除术组(n = 50)和腭裂修复术不联合翼钩切除术组(n = 50)。在术后1个月和6个月的随访中,使用客观测量方法(耳镜检查、鼓室图和耳声发射[OAE]测试)评估听力结果。采用卡方检验分析数据,显著性水平设定为p≤0.05。
在术后1个月和6个月的随访中,两组的耳镜检查、鼓室图和OAE测试结果在统计学上相似(p>0.05;卡方检验)。另一个值得注意的观察结果是随访期间听觉功能有所改善,这表明腭裂修复术后中耳功能得到了恢复。
在腭裂修复术中增加翼钩切除术可能会改善腭裂患者的听力结果,并且可以采用该方法实现无张力缝合。