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Abstract：
This study examined the effects of different types of tympanostomy tubes in pediatric patients undergoing cleft palate (CP) surgery in order to provide guidance for the proper insertion of tympanostomy tubes in the management of otitis media with effusion (OME). A total of 101 ears with middle ear effusion in 51 patients with CP were included in this study. Patients underwent palatoplasty and tympanostomy tube surgery at the same time. The type of tube inserted (Paparella type 1 or 2), the severity of CP, and types of palatoplasty surgeries were investigated. All patients were followed up for at least 6 months, and recurrence rates, complications, and reinsertion surgery were evaluated. The rate of OME recurrence after spontaneous tube extrusion was significantly higher in the type 1 group than in the type 2 group (44.3% vs. 19.4%, respectively, p = 0.016). Persistent eardrum perforation was more common in the type 2 group than in the type 1 group (41.9% vs. 12.9%, respectively, p = 0.001). The tube reinsertion rate was higher in the type 1 group than in the type 2 group (22.9% vs. 3.2%, respectively, p = 0.015). The tube reinsertion rate decreased to 8.6% in cases of palatoplasty with Sommerlad\'s technique, even with type 1 tube insertion, which was not significantly different from the reinsertion rate in the type 2 group (3.7%, p = 0.439). The Paparella type 1 tube would be a better choice in cases of palatoplasty performed using Sommerlad\'s technique, particularly considering the higher rate of persistent eardrum perforation after extrusion associated with the Paparella type 2 tube. Alternatively, a larger size type 2 tube may be considered in other surgeries to decrease the frequency of recurrence and tube reinsertion.
摘要：
这项研究检查了不同类型的鼓膜置管在接受left裂（CP）手术的小儿患者中的作用，以便为正确插入鼓膜置管以治疗渗出性中耳炎（OME）提供指导。本研究共纳入51例CP患者的101耳中耳积液。患者同时接受了腭成形术和鼓膜置管手术。插入的管的类型（Paparella类型1或2），CP的严重程度，并对腭成形术的手术类型进行了调查。所有患者均随访至少6个月。和复发率，并发症,并对再插入手术进行了评估。1型组自发性脱管后OME复发率明显高于2型组（44.3%vs.19.4%,分别,p=0.016)。持续性鼓膜穿孔在2型组中比在1型组中更常见(41.9%vs.12.9%,分别,p=0.001)。1型组管再插入率高于2型组（22.9%vs.3.2%,分别,p=0.015)。在Sommerlad技术下进行腭成形术的情况下，管的再插入率降至8.6％，即使有1型管插入，与2型组中的再插入率没有显着差异（3.7％，p=0.439)。在使用Sommerlad技术进行的par成形术的情况下，Paparella1型管将是更好的选择，特别是考虑到与Paparella2型管相关的挤压后持续鼓膜穿孔的较高比率。或者，在其他手术中可以考虑使用更大尺寸的2型管，以减少复发和重新插入管的频率。
