| Popis: |
Children with congenital perforating cleft lip and palate (CPCL&P) and congenital cleft palate (CCP) have significant changes in the external nose, intranasal structures, middle ear, lymphoid pharyngeal ring; one of the most frequent concomitant ENT pathologies is the secretory otitis media (SOM). SOM is one of the main causes of persistent conductive or mixed hearing loss in children due to the accumulation of exudates in the middle ear cavities. The risk of cholesteatoma in the patients with various types of clefts, according to the literature, is a sequence higher than in normal population. The authors analyzed multi-slice computed tomograms (MSCT) of 20 patients (n = 40 ears) aged 1 to 17 years before and after uranoplasty. All the children had a history of maxillofacial pathology and conductive or mixed hearing loss. A high percentage of reduced pneumatization in the attic (70% of cases) due to mucosal edema and secretion, including that after tympanostomy, indicates the long duration of the process of restoration of pneumatization and aeration of the middle ear cavities, which justifies the installation of long-term ventilation tubes. In unilateral process, the left ear is more often affected. Clinical and radiological manifestations on the part of the organ of hearing were more often worse on the side of the cleft with unilateral CPCL&P than in case of isolated CCP. Conducted uranoplasty does not exclude the risk of cholesteatoma. |
