Abstract：
UNASSIGNED: Persistent tympanic membrane perforation is a known complication of pressure-equalizing (PE) tube insertion. Conductive hearing loss and otorrhea can necessitate surgical repair of these perforations. Long-term tympanostomy tube placement can increase the risk of these complications. Patients with velocardiofacial syndrome (VCFS) typically require prolonged PE tube placement and are thought to have higher risk of requiring additional otologic interventions after PE tube placement. To date, no work has established rates of post-PE tube complications requiring myringoplasty or tympanoplasty in patients with VCFS.
UNASSIGNED: A retrospective case review including all patients with VCFS at a single large children\'s hospital between the years 2000 and 2020 was performed. Number of PE tube insertions required and additional otologic interventions performed were the primary endpoints assessed.
UNASSIGNED: Of 212 total patients with VCFS, 66 (31%) underwent PE tube placement. Of these children, 46 (70%) required 2 or more sets of PE tubes. A total of 53 patients (80.3%) required no otologic interventions apart from PE tube insertions. Of the 13 patients (19.7%) requiring additional otologic surgery, 6 (9.5%) underwent myringoplasty, and 9 patients (13.6%) required tympanoplasty. There was no significant difference in tympanoplasty (P > 1), myringoplasty (P > 1), or other surgical intervention rates (P = .7464) between VCFS patients with any type of cleft palate versus those with anatomically normal palates.
UNASSIGNED: This work suggests that most VCFS patients that require tubes, require at least 2 sets of PE tubes, and that the rate of post-PE tube complications requiring further otologic surgery is an order of magnitude higher than the rate established at this institution. Counseling for PE tube placement in VCFS patients may require specific dialogue regarding the substantially increased risk of complications and effort to build appropriate expectations for surgical outcomes regardless of palatal status.
UNASSIGNED: A retrospective case review including all patients with VCFS at a single large children\'s hospital between the years 2000 and 2020 was performed. Number of PE tube insertions required and additional otologic interventions performed were the primary endpoints assessed.
UNASSIGNED: Of 212 total patients with VCFS, 66 (31%) underwent PE tube placement. Of these children, 46 (70%) required 2 or more sets of PE tubes. A total of 53 patients (80.3%) required no otologic interventions apart from PE tube insertions. Of the 13 patients (19.7%) requiring additional otologic surgery, 6 (9.5%) underwent myringoplasty, and 9 patients (13.6%) required tympanoplasty. There was no significant difference in tympanoplasty (P > 1), myringoplasty (P > 1), or other surgical intervention rates (P = .7464) between VCFS patients with any type of cleft palate versus those with anatomically normal palates.
UNASSIGNED: This work suggests that most VCFS patients that require tubes, require at least 2 sets of PE tubes, and that the rate of post-PE tube complications requiring further otologic surgery is an order of magnitude higher than the rate established at this institution. Counseling for PE tube placement in VCFS patients may require specific dialogue regarding the substantially increased risk of complications and effort to build appropriate expectations for surgical outcomes regardless of palatal status.
摘要：
■持续鼓膜穿孔是压力平衡（PE）管插入的已知并发症。传导性听力损失和耳漏可能需要对这些穿孔进行手术修复。长期放置鼓膜置管会增加这些并发症的风险。心面综合征（VCFS）患者通常需要长时间放置PE管，并且被认为在放置PE管后需要额外的耳科干预的风险更高。迄今为止,在VCFS患者中,没有确定需要鼓膜成形术或鼓室成形术的PE管后并发症的发生率.
■在2000年至2020年期间，在一家大型儿童医院进行了回顾性病例回顾，包括所有VCFS患者。所需的PE管插入次数和进行的额外耳科干预是评估的主要终点。
■在212名VCFS患者中，66例（31%）接受了PE管放置。在这些孩子中,46（70％）需要2套或更多的PE管。除PE管插入外，共有53例患者（80.3％）无需耳科干预。在需要额外耳科手术的13例患者(19.7%)中，6人（9.5%）接受了鼓膜成形术，9例(13.6%)需要鼓室成形术。鼓室成形术无显著性差异(P>1),鼓膜成形术（P>1），或其他手术干预率（P=.7464）VCFS患者的任何类型的left裂与那些解剖正常的腭。
■这项工作表明，大多数需要插管的VCFS患者，至少需要2套PE管，需要进一步进行耳科手术的PE管后并发症的发生率比该机构确定的发生率高一个数量级。在VCFS患者中进行PE管放置的咨询可能需要进行有关并发症风险大幅增加的具体对话，并努力建立对手术结果的适当期望，而无论腭状态如何。
■在2000年至2020年期间，在一家大型儿童医院进行了回顾性病例回顾，包括所有VCFS患者。所需的PE管插入次数和进行的额外耳科干预是评估的主要终点。
■在212名VCFS患者中，66例（31%）接受了PE管放置。在这些孩子中,46（70％）需要2套或更多的PE管。除PE管插入外，共有53例患者（80.3％）无需耳科干预。在需要额外耳科手术的13例患者(19.7%)中，6人（9.5%）接受了鼓膜成形术，9例(13.6%)需要鼓室成形术。鼓室成形术无显著性差异(P>1),鼓膜成形术（P>1），或其他手术干预率（P=.7464）VCFS患者的任何类型的left裂与那些解剖正常的腭。
■这项工作表明，大多数需要插管的VCFS患者，至少需要2套PE管，需要进一步进行耳科手术的PE管后并发症的发生率比该机构确定的发生率高一个数量级。在VCFS患者中进行PE管放置的咨询可能需要进行有关并发症风险大幅增加的具体对话，并努力建立对手术结果的适当期望，而无论腭状态如何。
