[Characteristics of secretory otitis media in children with cleft palate and timing of intervention of tympanic membrane].

Objective

To explore the characteristics of otitis media with effusion(OME) in children with cleft palate(CP),including the incidence rate, age peak,relationship between cleft palate type and OME. And to explore the timing of VTI intervention in CP children with OME.Method: This study included congenital CP children who were plant to do palatoplasty.They all finished acoustic impedance tests and auditory brainstem responses(ABR) before surgery.Analyze the characteristics of OME and compare the hearing effects and complications between CP children underwent palatoplasty with VTI and those underwent palatoplasty without VTI.Result:The incidence of OME in CP children is 82% and the average is (11.59±6.60) months.The average ABR V wave threshold of CP children with OME is 46.5 dB nHL,of which about 68% children had moderate hearing loss. The latency of Ⅰ,Ⅲ and Ⅴ waves was prolonged, and there was no change in wave interval compared with whom without OME. The type of cleft palate was not related to the incidence of OME(χ²=2.532, P=0.639).Compared with the preoperative hearing thresholds, the percentage of hearing recovery in 1 month,6 months and 12 months after VTI was 92.4%, 92.2% and 96.2% respectively.Persistent OME still exists in 41% of the children in the only palatoplasty group after operation.

Conclusion

It is found that the incidence of OME in CP children is higher, the average age is earlier, and the degree of hearing loss is greater. Thus, no matter what the the type of cleft palate is,the doctors should pay attention to the hearing status of the CP children.If they are accompanied by OME with hearing loss, VTI is needed at the same time of palatoplasty.Palatoplasty alone has limitations on hearing improvement in some children with cleft palate.