Kane A A, Lo L J, Yen B D, Chen Y R, Noordhoff M S
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Cleft Palate Craniofac J. 2000 Sep;37(5):506-11. doi: 10.1597/1545-1569_2000_037_0506_teohfo_2.0.co_2.
To determine whether, in performing palatoplasty, fracture of the pterygoid hamulus is beneficial, detrimental, or neutral with respect to intraoperative and perioperative complications, hearing outcome, and speech outcome.
Prospective, alternating.
Institutional, tertiary cleft palate center, Chang Gung Memorial Hospital, Taipei, Taiwan.
A total of 173 patients enrolled in the study, of whom 161 had charts available for analysis.
During the performance of palatoplasty, 85 patients received hamulus fracture and 76 patients did not. All palatoplasties were performed by the same surgeon.
(1) Surgical outcomes, including patient demographic data, palatoplasty type and duration, blood loss, incidences of oronasal fistulae, temporary mucosal dehiscence, and postoperative bleeding; (2) otolaryngological outcomes, including hearing results as judged by auditory brainstem response testing, myringotomy tube data describing rates of tube extrusion, and culture results from sampled effusions; and (3) preliminary speech outcomes as described by judgments of overall velopharyngeal function from perceptual speech samples.
No statistically significant differences in any of the measured surgical, otolaryngological, or preliminary speech outcomes were found between the groups who did and did not receive hamulus fracture.
On the basis of these results, we are unable to advocate the performance of hamulus fracture as an operative maneuver during the performance of primary palatoplasty. The historical rationale and theoretical advantage of this maneuver have not been demonstrated here nor have any detrimental effects of the maneuver been measured.
确定在腭裂修复术中，翼钩骨折对术中及围手术期并发症、听力结果和语音结果而言是有益、有害还是中性的。
前瞻性、交替性。
台湾台北长庚纪念医院三级腭裂中心。
共有173名患者纳入本研究，其中161名有可供分析的病历。
在腭裂修复术中，85名患者接受了翼钩骨折，76名患者未接受。所有腭裂修复术均由同一位外科医生进行。
（1）手术结果，包括患者人口统计学数据、腭裂修复术类型和持续时间、失血量、口鼻瘘、暂时性黏膜裂开和术后出血的发生率；（2）耳鼻喉科结果，包括通过听觉脑干反应测试判断的听力结果、描述鼓膜切开置管脱出率的鼓膜切开置管数据以及积液样本的培养结果；（3）根据语音样本的感知判断所描述的初步语音结果，即整体腭咽功能。
接受和未接受翼钩骨折的两组患者在任何测量的手术、耳鼻喉科或初步语音结果方面均未发现统计学上的显著差异。
基于这些结果，我们无法主张在一期腭裂修复术中将翼钩骨折作为一种手术操作。该操作的历史依据和理论优势在此未得到证实，也未测量该操作的任何有害影响。
