- 期刊
唇顎裂和非唇顎裂兒童以通氣管治療中耳積水後的聽力評估
Hearing Assessment of Children with and without Cleft Lip and Palate Suffering from Middle Ear Effusion Treated with Ventilation Tube Insertion
摘要
背景：探討有中耳積水病史的唇顎裂兒童在中耳通氣管置入手術後，與有中耳積水病史且接受過中耳通氣管置入手術的非唇顎裂兒童做臨床預後及聽力的比較。方法：回溯從2005年到2014年曾經接受過中耳通氣管置入手術的唇顎裂兒童以及接受過中耳通氣管置入手術的非唇顎裂兒童的病歷和聽力檢查報告。收集資料包含個案的性別、出生年月日、聽力檢查時間、聽力圖、鼓室圖、中耳通氣管置入手術年齡、中耳通氣管置入次數和術後耳部的狀況等。結果：本研究共篩選及收集的唇顎裂個案共90名，180隻耳朵，而非唇顎裂個案共89名，178隻耳朵。唇顎裂兒童的第一次中耳通氣管置入手術平均年齡為1.54歲，非唇顎裂兒童的平均年齡為6.26歲，達到顯著差異。唇顎裂兒童的氣導、骨導平均閾值較非唇顎裂兒童來得差，而唇顎裂兒童術後鼓室圖呈現B、Ad型百分比顯著高於非唇顎裂兒童，唇顎裂兒童在接受2次(或以上)手術的百分比顯著高於非唇顎裂兒童。結論：本研究發現，唇顎裂兒童的聽力及中耳狀況，和非唇顎裂兒童相比較則是明顯較差，中耳通氣管置入手術年齡較早、次數較多，術後鼓膜異常情況較多且聽力也較差。建議唇顎裂兒童應在接受中耳通氣管置入手術後，定期追蹤中耳及聽力狀況。
並列摘要
BACKGROUND: We compared the clinical prognoses and hearing outcomes of children with and without a cleft lip and palate (CLP) who developed a middle ear effusion (MEE) after surgery featuring ventilation tube insertion. METHODS: We retrospectively reviewed medical and hearing data on CLP and non- CLP children who underwent ventilation tube insertion between 2005 and 2014. We recorded gender, date of birth, the dates of hearing tests, preoperative pure tone audiometric and tympanographic data, the age at and frequency of ventilation tube insertion, and postoperative hearing status. RESULTS: Ninety CLP cases (180 ears) and 89 non-CLP cases (178 ears) were evaluated. The average age of the CLP children who underwent ventilation tube insertion was 1.54 years, significantly ( p ＜ 0.001) younger than that of the non-CLP children (6.26 years). After surgery, the average air and bone conduction thresholds of the CLP children were higher than those of the non-CLP children, and the proportion of children with type B and Ad tympanograms was significantly higher among CLP than non-CLP children. In addition, the proportion of CLP children undergoing two or more surgeries was significantly ( p ＜ 0.001) higher than that of non-CLP children. CONCLUSIONS: The hearing and middle ear status of CLP children are poorer than those of non-CLP children. The former children undergo more frequent ventilation tube insertion at an earlier age, have a higher proportion of abnormal eardrums, and experience poorer hearing outcomes. We suggest that the postoperative middle ear and hearing status of CLP children be monitored regularly.
延伸閱讀
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