口蓋裂一次手術時における滲出性中耳炎の統計的観察

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  • Statistical Observation of Otitis Media with Effusion at the Time of the Primary Cleft Palate Surgery
  • 臨床 口蓋裂一次手術時における慘出性中耳炎の統計的観察
  • リンショウ コウガイレツイチジ シュジュツジ ニ オケル サンシュツセイ チュウジエン ノ トウケイテキ カンサツ

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We conducted a retrospective epidemiological survey to clarify the current status of otitis media with effusion (hereafter, OME) at the time of primary cleft palate surgery at our otorhinolaryngology department. We selected a total of 227 patients (118 boys [52%], 109 girls [48%], mean age: 1.89±0.4 years old) who had undergone primary cleft palate surgery at the oral surgery department of our hospital during the 5-year period from December 2006 to November 2011. At our hospital, two-stage surgery is adopted for palatoplasty, and the primary surgery is usually performed when a patient is around one and half years old. Basically, all the patients undergo medical examination at the otorhinolaryngology department before palatoplasty, and any patients detected to have OME are subjected to myringotomy or ventilating tube insertion at our department.<br> The prevalence of OME during the primary cleft palate surgery was about 60%. No relation was observed between the presence or absence of OME and the presence or absence of any factors, such as the type of cleft palate, gender, height, weight, or associated malformation. The morbidity of OME was significantly higher in the patients who had consulted a previous otorhinolaryngologist before visiting our department. Thus, the effectiveness of preoperative diagnosis of myringotomy was demonstrated. There were many cases of myringotomy, while cases of ventilating tube insertion accounted for only 16%, less than that reported from many other facilities.<br> Since our department has conventionally limited medical treatment of OME to myringotomy, we actually had a low rate of it this procedure. The pros and cons of tube insertion are controversial, therefore, further consideration would be necessary to identify the factors influencing the occurrence of OME and to decide or validate the treatment course.<br>

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