Pulkkinen J, Haapanen M L, Paaso M, Laitinen J, Ranta R
Cleft Centre, Department of Plastic Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Folia Phoniatr Logop. 2001 Mar-Apr;53(2):93-8. doi: 10.1159/000052659.
The purpose of this investigation was to study changes of velopharyngeal function between the ages of 3 and 8 years. The subjects were 65 (30 girls and 35 boys) Finnish-speaking non-syndromic children with isolated cleft palate (CP, n = 35) and with unilateral cleft lip and palate (UCLP, n = 30) operated primarily at the age of 1.0-2.0 years. Before the age of 8 years, 16 children required velopharyngoplasty (VPP, ad modum Hoenig). The children were followed up for speech at the age of 3, 6 and 8 years. The perceptual speech characteristics nasal air emission, hypernasality, weakness of pressure consonants and compensatory articulations were registered. Indications for a velopharyngeal flap (by VPP) were identified on the basis of perceptual speech characteristics and confirmed by instrumental examinations. The results indicated that the method and timing of primary palatoplasty and sex did not correlate with the quality of velopharyngeal function. It was good both in children treated conservatively or with VPP at the age of 8 years. The children with a flap required speech therapy significantly more often than other children. No child with VPP and only 12% of the children without VPP had simultaneous nasal air emissions and hypernasality. Compensatory articulation was completely eliminated and weakness of pressure consonants was diagnosed only in 1 child without VPP. The CP children required significantly more often a velopharyngeal flap than the UCLP children. In conclusion, the CP and UCLP children develop a similar velopharyngeal function but in a different way.
本研究的目的是探讨3至8岁儿童腭咽功能的变化。研究对象为65名（30名女孩和35名男孩）说芬兰语的非综合征性儿童，其中单纯腭裂（CP，n = 35）和单侧唇腭裂（UCLP，n = 30）的患儿主要在1.0 - 2.0岁时接受了手术。在8岁之前，16名儿童需要进行腭咽成形术（VPP，采用Hoenig法）。对这些儿童在3岁、6岁和8岁时进行了语音随访。记录了感知语音特征，包括鼻漏气、鼻音过重、塞音弱化和代偿性发音。根据感知语音特征确定腭咽瓣（通过VPP）的适应证，并通过仪器检查加以证实。结果表明，一期腭裂修复术的方法和时机以及性别与腭咽功能质量无关。在8岁时，接受保守治疗或VPP治疗的儿童腭咽功能均良好。接受腭咽瓣治疗的儿童比其他儿童更频繁地需要言语治疗。接受VPP治疗的儿童中没有出现同时存在鼻漏气和鼻音过重的情况，而未接受VPP治疗的儿童中只有12%出现这种情况。代偿性发音完全消除，只有1名未接受VPP治疗的儿童被诊断为塞音弱化。CP患儿比UCLP患儿更频繁地需要腭咽瓣。总之，CP和UCLP患儿腭咽功能的发展相似，但方式不同。
