Study Of Palatoplasty On Auditory Status Of Infants With Cleft Lip And/or Palate

[Objective]To understand the situation of the middle ear function and hearing level of infants with cleft palate. To study the effects of palatoplasty on auditory status of infants with cleft lip and / or palate.[Method]This study included 122 patients with cleft palate (CP) and 37 patients with cleft lip (CL) treated in CLP Department of Guangzhou Women and Children's Medical Center from 2006 to 2010. In the study, the middle ear function and hearing level were compared between CP and CL patients. The relationships between age, CP type and palatoplasty were analyzed. All the date was statistically analyzed by SPSS11.0 software.[Result]In all cases, there were 102 male and 57 female, with the male to female ratio 1.8:1. And there were 37 CL cases, 47 incomplete CP(with / without CL) and 75 complete CP (with / without CL). The youngest patient is 1 month, and the oldest is 2 years old. Mean age is 6.9 months.1. The middle ear function was worse in patients with CP than those with CL.2. The wave V reacting thresholds of ABR was (58.23±15.878) dBnHL in CP patients and (40.31±6.370)dBnHL in CL patients, so there was significant difference between them.3. With age increasing, the middle ear function of patients with CP became worse on the whole, however, it became better in 13-18m group.4. With age increasing, the amount of tympanogram B and C increased, however, it became less in 13-18m group.5. With age increasing, the hearing level of patients with CP improved on the whole, however, it became worse in 13-18m group, on the contrary of the middle ear function.6. The middle ear function and the hearing level of patients with submucous CP were better than those of patients with other CP types.7. There was no significant difference between left ears and right ears in each CP type with regards to middle ear function and hearing level.8. The middle ear function disaccorded with the average wave V reacting thresholds of ABR.9. The hearing level was improved after palatoplasty. The wave V reacting thresholds of ABR was (60.00±14.853)dBnHL pre operation and (48.67±12.488)dBnHL post operation. But the middle ear function had no significant difference between pre and post operation.[Conclusion]In recent years, middle ear function and hearing problems of patients with CP had gradually been paid much attention domestically. However, most studies focused on adults and older children and few were about infants. It was concluded that the prevalence of hearing loss in infants with CP was relatively high. This was related to the anatomy of CP, organizational structure and other relevant abnormalities. The hearing level was partly improved after palatoplasty, but the middle ear dysfunction persisted. These meant that patients with CP needed early surgery to restore velopharyngeal, but it can not fully improve the middle ear function. As the result, they needed regular hearing tests and hearing assessment. Proper treatments improved middle ear function and reduced hearing loss, which was in favor of the language and intellectual development.