腭裂患儿腭裂修补术后分泌性中耳炎的转归

金蕾;汪景;李晓艳;

1:上海交通大学医学院附属儿童医院耳鼻咽喉头颈外科

摘要

目的分析腭裂患儿腭裂修补术后分泌性中耳炎的转归，为分泌性中耳炎置管时机的选择提供参考。方法回顾性分析2015年10月至2020年6月共50例不完全性腭裂患儿的临床资料，术前均行声导抗、耳声发射、气骨导ABR和腭部CT平扫检查，明确是否伴发分泌性中耳炎；在腭裂修补术后随访至少6个月，术后1、3、6、12月复查声导抗和耳声发射。如果术后6月合并分泌性中耳炎患儿没有好转，则行鼓膜切开置管术。结果 50例中47例(47/50,94.0%)患儿有单侧(10例)或双侧(37例)分泌性中耳炎。47例中，6例在腭裂修补术后1个月时分泌性中耳炎好转，7例在术后6个月时好转，1例患儿拒绝鼓膜置管术在术后1年时好转，这14例ABR反应阈为30.2±5.8 dB nHL,术后半年时分泌性中耳炎自愈率为27.6%(13/47)。余33例术后半年时分泌性中耳炎未缓解，故行鼓膜置管术，术后1月ABR反应阈为35.2±6.5 dB nHL。结论不完全腭裂患儿分泌性中耳炎发生率较高，腭裂修补术后建议随访半年，如果术后半年分泌性中耳炎未好转再行鼓膜置管术。

关键词

分泌性中耳炎;腭裂;腭裂修补术

基金项目(Foundation):

上海市儿童医院青年基金培育项目（2018YQN010）

作者

金蕾;汪景;李晓艳;

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分泌性中耳炎腭裂腭裂修补术

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金蕾汪景李晓艳