Prosak Olivia L, Du Jennifer, Gao Lily, Patel Kalpnaben R, Zhao Shilin, Braun Stephan, Golinko Michael, Phillips James D, Belcher Ryan H
Department of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Surgical Outcomes Center for Kids (SOCKS), Vanderbilt University Medical Center, Nashville, TN, USA.
Cleft Palate Craniofac J. 2025 Feb;62(2):179-187. doi: 10.1177/10556656241308347. Epub 2025 Jan 9.
ObjectiveTo determine whether palatoplasty technique affects the resolution of eustachian tube dysfunction and postoperative speech outcomes in children with cleft palate (CP).DesignRetrospective cohort.SettingMultidisciplinary cleft and craniofacial clinic at a tertiary care center.PatientsSeventy-three patients with nonsyndromic CP who underwent palatoplasty between 2005 and 2019. Inclusion criteria included soft palate repair with Furlow technique or intravelar veloplasty (IVV) and Veau classifications I-III.InterventionsEither Furlow or IVV repair was performed based on the surgeon's clinical judgment. All patients had bilateral ear tubes placed prior to or at the time of palate repair, with postpalatoplasty ear tubes placed at the ENT surgeon's discretion. Patients received routine follow-up care for over 5 years. Data were analyzed with Wilcoxon tests, χ tests, and negative binomial regression.Main Outcome MeasuresNumber of postpalatoplasty ear tubes placed, rates of velopharyngeal insufficiency, and speech surgery after palatoplasty in each group.ResultsFurlow repair patients required a similar number of postpalatoplasty ear tubes ( = .321) and underwent additional sets at similar rates compared to those who underwent IVV repair. Negative binomial regression found no covariates (age, race, Veau, repair type, speech surgery, fistula repair) that predicted additional ear tube requirements.ConclusionFurlow repair patients required postpalatoplasty ear tubes at a similar rate compared to IVV repair patients. While the palatoplasty techniques differ, patients may still need the same amount of time for resolution of their eustachian tube dysfunction.
目的
确定腭裂修复技术是否会影响腭裂(CP)患儿咽鼓管功能障碍的恢复以及术后语音结果。
设计
回顾性队列研究。
设置
三级医疗中心的多学科腭裂和颅面诊所。
患者
2005年至2019年间接受腭裂修复术的73例非综合征性CP患者。纳入标准包括采用Furlow技术或腭内肌成形术(IVV)进行软腭修复以及Veau分类为I - III级。
干预措施
根据外科医生的临床判断进行Furlow或IVV修复。所有患者在腭裂修复术前或术中放置双侧耳管,腭裂修复术后耳管的放置由耳鼻喉科医生决定。患者接受了超过5年的常规随访。数据采用Wilcoxon检验、χ检验和负二项回归分析。
主要观察指标
每组腭裂修复术后放置耳管的数量、腭咽闭合不全的发生率以及腭裂修复术后的语音手术情况。
结果
与接受IVV修复的患者相比,Furlow修复患者腭裂修复术后所需耳管数量相似(P = 0.321),且额外放置耳管的比例相近。负二项回归分析未发现预测额外耳管需求的协变量(年龄、种族、Veau分类、修复类型、语音手术、瘘管修复)。
结论
与IVV修复患者相比,Furlow修复患者腭裂修复术后需要放置耳管的比例相似。虽然腭裂修复技术不同,但患者咽鼓管功能障碍的恢复可能仍需要相同的时间。