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腭裂修复术技术会影响咽鼓管功能障碍的解决吗?

Does Palatoplasty Technique Impact Resolution of Eustachian Tube Dysfunction?

作者信息

Prosak Olivia L, Du Jennifer, Gao Lily, Patel Kalpnaben R, Zhao Shilin, Braun Stephan, Golinko Michael, Phillips James D, Belcher Ryan H

机构信息

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.

出版信息

Cleft Palate Craniofac J. 2025 Feb;62(2):179-187. doi: 10.1177/10556656241308347. Epub 2025 Jan 9.

DOI:10.1177/10556656241308347
PMID:39782704
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11909771/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c7/11909771/69e6a259700a/10.1177_10556656241308347-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c7/11909771/69e6a259700a/10.1177_10556656241308347-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39c7/11909771/69e6a259700a/10.1177_10556656241308347-fig1.jpg

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本文引用的文献

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Plast Reconstr Surg. 2024 Jun 1;153(6):1155e-1168e. doi: 10.1097/PRS.0000000000010798. Epub 2023 Jun 6.
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Impact of palatoplasty techniques on tympanic membrane findings and hearing prognosis in children with cleft palate.腭裂患儿的腭成形术技术对鼓膜表现和听力预后的影响。
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An Enhanced Audiologic Protocol for Early Identification of Conductive Hearing Loss in Patients with Cleft Palate.
增强型听力学方案在腭裂患者传导性听力损失早期识别中的应用。
Cleft Palate Craniofac J. 2024 Oct;61(10):1657-1662. doi: 10.1177/10556656231178437. Epub 2023 May 24.
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The Incidence of Velopharyngeal Insufficiency in Stickler Syndrome.斯特格氏综合征患者的软腭闭合不全发生率。
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Efficacy of Ventilation Tube Insertion with Palatal Repair for Otitis Media in Cleft Palate: Meta-Analysis and Trial Sequential Analysis.腭裂修复术中插入通气管治疗中耳炎的疗效:Meta分析和试验序贯分析
J Pers Med. 2022 Feb 10;12(2):255. doi: 10.3390/jpm12020255.
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Predictive Factors for Velopharyngeal Insufficiency Following Primary Cleft Palate Repair.腭裂修复术后咽腔闭合不全的预测因素。
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Cleft Palate Craniofac J. 2021 Apr;58(4):479-488. doi: 10.1177/1055665620954063. Epub 2020 Oct 5.
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Eustachian Tube Dysfunction in Children With Unilateral Cleft Lip and Palate: Differences Between Ipsilateral and Contralateral Ears.单侧唇腭裂患儿的咽鼓管功能障碍:患侧耳与对侧耳的差异
Cleft Palate Craniofac J. 2020 Jun;57(6):723-728. doi: 10.1177/1055665619895635. Epub 2019 Dec 23.
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