Yo-IFOS关于唇腭裂儿童听力管理的调查

文献信息

中文摘要

引言： 腭裂儿童面临较高的分泌性中耳炎（OME）和传导性听力损失风险。本调查评估了该人群听力监测与管理方面的当代全球实践模式。
方法： 一项包含43个条目的横断面调查于2026年1月至3月期间以电子方式分发给国际儿科耳鼻喉科医生。问卷评估了监测方案、OME干预措施、鼓膜置管（TT）偏好、替代听力康复方法以及机构资源障碍。
结果： 67名临床医生参与，主要来自大学或三级医疗保健机构（85.1%）。72.7%的参与者来自高收入国家，而27.3%来自低收入和中等收入国家。对于OME管理，50.7%的受访者将TT置入作为首选一线选择，但回答在置入时机方面显示出显著差异。如果手术不可行，53.7%将助听放大作为一线替代方案。大多数临床医生（85.1%）避免咽鼓管球囊扩张。50.7%对综合征型腭裂病例采用强化监测。尽管77.6%的受访者在高资源中心执业，但最佳护理的主要障碍包括预约等待时间过长（25.4%）和家庭认知度低（22.4%）。
结论： 尽管耳鼻喉科和听力学监测已广泛纳入国际腭裂诊疗路径，但参与国家和地区之间在外科指征、TT置入时机和随访方面仍存在显著差异。这些发现凸显了制定国际共识和循证指南以标准化腭裂相关听力管理并优化长期结局的必要性。

英文摘要

INTRODUCTION: Children with cleft palate face a high risk of otitis media with effusion (OME) and conductive hearing loss. This survey evaluated contemporary global practice patterns in hearing surveillance and management within this cohort.
METHODS: A 43-item cross-sectional survey was electronically distributed to international pediatric otolaryngologists between January and March 2026. The questionnaire evaluated surveillance protocols, OME interventions, tympanostomy tube (TT) preferences, alternative hearing rehabilitation, and institutional resource barriers.
RESULTS: Sixty-seven clinicians participated, primarily from university or tertiary healthcare settings (85.1%). 72.7% of the participants were from high-income countries, while 27.3% were from low- and middle-income countries. For OME management, TT insertion was the preferred first-line choice for 50.7%, though responses showed marked variation regarding timing of insertion. If surgery was unfeasible, 53.7% utilized hearing amplification as a first-line alternative. Most clinicians (85.1%) avoided Eustachian tube balloon dilatation. Intensive surveillance was adopted by 50.7% for syndromic cleft cases. Principal barriers to optimal care included prolonged appointment wait times (25.4%) and low family awareness (22.4%), despite 77.6% of respondents practicing in high-resource centers.
CONCLUSION: Although otolaryngology and audiology surveillance is widely embedded in international cleft pathways, substantial variation across participating countries and regions persists regarding surgical indications, timing of TT insertion, and follow-up. These findings highlight a need for international consensus and evidence-based guidelines to standardize cleft-related hearing management and optimize long-term outcomes.