关键词: infant, cleft palate, secretory otitis media, myringotomy with insertion of tube, tympanocentesis

Abstract:

Objective To explore the effect of myringotomy with insertion of tube and tympanocentesis on alleviating secretory otitis media（SOM） and hearing loss in cleft palate infants. Methods Nineteen cleft lip and palate infants with SOM and hearing loss （38 ears）were treated with myringotomy with insertion of ventilation tube at the same time of repair of the cleft lip, who were performed averagely at 6.9 months of age. Fifteen cleft lip and palate infants with SOM（30 ears） were treated with tympanocentesis at the same time of repair of the cleft lip averagely at 6.6 months of age. All cases were followed up from 1 week to 12 months and estimated by auditory brainstem response（ABR） and acoustic immitance audiometry. Results The average wave Ⅴ reacting thresholds of ABR were separately 55.41 dBnHL and 28.48 dBnHL, and 79.17% tympanogram B changed to tympanogram A in cleft palate infants with insertion of tube before and after operation. The average wave Ⅴ reacting thresholds of ABR were separately 40.63 dBnHL and 26.50 dBnHL, and 40.91% tympanogram B changed to tympanogram A in cleft palate infants with tympanocentesis preoperatively and in 1 week postoperatively, in whom the average hearing thresholds and tympanograms had no significant difference preoperatively and in 1 or 3 months postoperatively（P>0.05）. Conclusion The early myringotomy with insertion of tube is effective to restore the function of the middle ear in cleft palate infants with SOM, so to suggest to be performed at the same time of the repair of cleft lip within the first 1- year of life. The tympanocentesis should not be used as a regular management in the cleft palate infants with SOM.

Key words: 婴儿, 腭裂, 分泌性中耳炎, 鼓室置管, 鼓膜穿刺