口腔医学研究

口腔医学研究 ›› 2019, Vol. 35 ›› Issue (11): 1035-1039.DOI: 10.13701/j.cnki.kqyxyj.2019.11.007

• 口腔颌面外科学研究 • 上一篇    下一篇

Furlow腭成形术和两瓣法修复腭裂后腭咽闭合功能的研究

何慧君1,2, 傅豫川1, 陈慧兰1, 米热古丽·图尔荪江1, 柯金1, 蔡恒星1, 龙星1, 李健1*   

  1. 1. 口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室,武汉大学口腔医学院 湖北 武汉 430079;
    2. 泰康同济(武汉)医院 湖北 武汉 430000
  • 收稿日期:2019-01-23 出版日期:2019-11-28 发布日期:2019-11-21
  • 通讯作者: 李健,E-mail:lijian_hubei@whu.edu.cn
  • 作者简介:何慧君(1992~ ),女,安徽芜湖人,硕士,从事口腔颌面外科相关临床工作。
  • 基金资助:
    武汉市唇腭裂序列治疗临床医学研究中心项目(编号:304-230100041)

Research on the Velopharyngeal Function between Furlow Palatoplasty and Two-flap Method in Repairing Cleft Palate

HE Huijun1,2, FU Yuchuan1, CHEN Huilan1, MIREGULI·Tuersunjiang1, KE Jin1, CAI Hengxing1, LONG Xing1, LI Jian1*   

  1. 1. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan University, Wuhan 430079, China;
    2.Taikang Tongji Hospital, Wuhan 430000, China
  • Received:2019-01-23 Online:2019-11-28 Published:2019-11-21

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摘要： 目的: 应用Furlow腭成形术和两瓣法对腭裂患者进行修复,评估并比较其术后语音效果及腭咽闭合功能,为进一步的语音治疗或手术治疗提供依据,同时预测可能影响术后效果的因素。方法: 选取2010年1月~2016年12月来武汉大学口腔医院唇腭裂专科就诊的84例腭裂患者,其中男40例,女44例,年龄8~12个月,采用Furlow腭成形术进行修复者为45例,两瓣法39例,术者均为同一资深的手术医师。术后定期随访3~5年,由专业语音师评估其语音效果,拍摄头影测量侧位片并用鼻咽纤维镜检测其腭咽闭合情况。结果: Furlow腭成形术的患者与两瓣法的患者在术后PSA评分,the need ratio(咽腔深度/软腭长度,PW/PU)、矢状位软腭运动闭合程度(BC/BD)及腭咽闭合率等指标有统计学差异(P<0.05);而在软腭上抬角度∠B2PC2上没有统计学差异。结论: Furlow腭成形术和两瓣法均能有效修复腭裂患者,Furlow腭成形术结合腭帆提肌重建和反向双Z成形能获得更好的腭咽闭合和语音效果。

关键词: 腭裂, 腭咽闭合, Furlow腭成形术, 两瓣法, 语音评估

Abstract: Objective: To evaluate and compare the voice effects and velopharyngeal function of cleft palate repaired with Furlow palatoplasty and two-flap method. Methods: Eighty-four patients with cleft palate who come for clinic at Hospital of Stomatology Wuhan University from January 2010 to December 2016 were selected, including 40 males and 44 females, at the age of 8 months to 12 months. Forty-five cases were treated with Furlow palatoplasty, while 39 cases were repaired by two-flap method. The surgeon was the same physician. Postoperative speech assessments were done by professional speech therapist, and the cephalometric measure and nasoendoscopy were made to detect the velopharyngeal closure. Results: There was a significant statistical difference between Furlow palatoplasty and two-flap method in the PSA scores, the need ratio (PW/PU), the degree of sagittal palatopharyngeal closure (BC/BD), and the velopharyngeal closure rate. There was no significant difference in the elevation angle of the soft palate. Conclusion: Both Furlow palatoplasty and two-flap method can effectively repair cleft palate patients. Furlow palatoplasty can improve the speech more effectively by reconstructing the levator veli palatini and reverse double Z plasty.

Key words: cleft palate, velopharyngeal closure, Furlow palatoplasty, two-flap method, speech assessment