摘要
目的：探讨一种具有良好腭咽功能、对上颌生长发育影响小的不完全性腭裂修复的新方法。方法：采用Sommerlad腭帆提肌重建术，对38例不完全性腭裂进行手术修复，术后应用语音分析、头颅侧位X线咽腔造影检查。结果：所有患者术后均一期愈合。28例（73．7％）没有做松弛切口，10例（26．3％）行两侧约5～10mm松弛切口。20例术后6个月复诊，其语音清晰度、高鼻音以及鼻漏气都得到明显改善。咽腔造影结果显示：17例达到完全腭咽闭合，3名软腭动度良好，发“i”时腭咽间隙在3mm以内。结论：Sommerlad腭帆提肌重建术可有效恢复腭帆提肌正常的解剖结构和位置，重建提腭吊带，获得良好的腭咽闭合；并可尽量不做松弛切口，避免了硬腭裸露骨面造成对上颁生长发育的影响，较好地解决了传统术式所遗留的问题，是一种值得推荐应用的功能性腭裂修复方法。
Objective： To explore a functional palatoplasty resulting in velopharyngeal competence without interfering significantly with the maxillary growth in the treatment of isolated cleft palate. Metlmd：A total of 38 patients with isolated cleft palate underwent Sommerlad palatoplasty from June, 2004 to Feb, 2005. The mean follow-up time was 6 - 12 months. Speech characteristics were assessed perceptual by an experienced Speech-language pathologist and velopharyngeal function was evaluated using lateral cephalometrics. Result： Orgy cleft marginal incision with no lateral inclslon（Langenbeck flap） were made in 75% （28） of all patient repair. 25% （10） of aU patient needed miminal lateral incision with less than 10 ram. 20 patients Were followed up. There were significant improvement in hypernasality, r,~l emission and intelligibity. 17 patients achieved veloptmryngeal cccnpetence. 3 patients showed improvement on lateral cephalornetrics with good velar movement and a decrease in gap size. Conclusion： It suggestes that Somrnerlad palatoplasty＇is a useful procedure for isolated cleft palate repair with retropositioning the abnormally oriented velar muscle into a more normal anatamatical, posterior position and reconstructing levator sling to reach velopharyngeal competence. Furthmore , the technique that leaves no denuded palatal hone is considered to be advantageous for maxillary growth, which is worthy of further application.
出处
《临床口腔医学杂志》
2006年第4期233-236,共4页
Journal of Clinical Stomatology
基金
四川省重点科技资助项目(03SG022-002)
