Lin K Y, Goldberg D, Williams C, Borowitz K, Persing J, Edgerton M
Department of Plastic Surgery, University of Virginia, Health Sciences Center, Charlottesville 22908, USA.
Cleft Palate Craniofac J. 1999 Jan;36(1):73-8. doi: 10.1597/1545-1569_1999_036_0073_ltoaot_2.3.co_2.
Two surgical techniques for repair of a cleft palate include levator retropositioning in combination with a pharyngeal flap and the Furlow double-opposing Z-plasty. This study compared morbidity and speech results from the use of these two methods in an effort to determine which was the superior technique.
Patient records from 1986 to 1996 were retrospectively reviewed, and 10 patients with a cleft palate who underwent repair with a levator retropositioning and pharyngeal flap were compared to 14 patients who underwent a double-opposing Z-plasty repair. Postoperative complications including fistula formation, obstructive sleep apnea, and residual velopharyngeal insufficiency were recorded. Speech was assessed perceptually and through the use of nasometry.
Both surgical techniques resulted in good speech in the majority of patients. Only two patients in the study, both in the Z-plasty group, had severe postoperative hypernasality. Two patients in the levator retropositioning and pharyngeal flap group developed severe postoperative obstructive sleep apnea, requiring additional surgery.
The levator retropositioning and pharyngeal flap technique was successful in achieving good speech results, but it also caused more serious postoperative complications when compared to the double-opposing Z-plasty technique.
腭裂修复的两种手术技术包括提肌复位联合咽瓣术和弗洛（Furlow）双反向Z成形术。本研究比较了使用这两种方法的发病率和语音结果，以确定哪种技术更优越。
回顾性分析1986年至1996年的患者记录，将10例行提肌复位和咽瓣术修复腭裂的患者与14例行双反向Z成形术修复的患者进行比较。记录术后并发症，包括瘘管形成、阻塞性睡眠呼吸暂停和残留腭咽闭合不全。通过听觉评估和鼻音测量对语音进行评估。
两种手术技术在大多数患者中均产生了良好的语音效果。研究中只有两名患者，均在Z成形术组，术后出现严重鼻音过重。提肌复位和咽瓣术组有两名患者术后出现严重阻塞性睡眠呼吸暂停，需要再次手术。
提肌复位和咽瓣术技术成功实现了良好的语音效果，但与双反向Z成形术技术相比，它也导致了更严重的术后并发症。
