Riski J E, Ruff G L, Georgiade G S, Barwick W J, Edwards P D
Department of Surgery, Duke University Medical Center, Durham, NC 27710.
Cleft Palate Craniofac J. 1992 May;29(3):254-61. doi: 10.1597/1545-1569_1992_029_0254_eotsp_2.3.co_2.
The results of the sphincter pharyngoplasty were evaluated in 139 patients with velopharyngeal incompetence (VPI) who demonstrated active velar elevation. All patients underwent perceptual speech evaluation and lateral phonation radiographic study; select patients underwent multiview videofluoroscopic, flexible nasendoscopic, and pressure-flow studies. All but one patient demonstrated improvement and 109/139 (78.42%) demonstrated resolution of VPI. Sixteen of thirty failed pharyngoplasties were revised. Revision was successful in 8/16 patients yielding an overall success rate of 117/139 (84.17%). Success rate was 67.65 percent for patients managed during the first 5 years and improved to 84.78 percent for patients managed during the last 5 years of this 15-year series. Analysis revealed that younger patients were treated more successfully than older patients, large velopharyngeal areas were treated as successfully as smaller ones, and circular closure patterns were treated more successfully than coronal patterns. The primary cause of failure was insertion of the flap below the point of attempted velopharyngeal contact.
对139例腭咽闭合不全（VPI）且软腭有主动抬高的患者的咽括约肌成形术结果进行了评估。所有患者均接受了感知语音评估和侧位发声X线片研究；部分患者还接受了多视角荧光透视、软性鼻内镜及压力-流量研究。除1例患者外，所有患者均有改善，109/139（78.42%）的患者腭咽闭合不全得到解决。30例失败的咽成形术中，有16例进行了修复。8/16的患者修复成功，总体成功率为117/139（84.17%）。在这15年的研究系列中，前5年治疗的患者成功率为67.65%，后5年治疗的患者成功率提高到84.78%。分析显示，年轻患者比老年患者治疗更成功，腭咽面积大的患者与面积小的患者治疗效果一样成功，圆形闭合模式比冠状模式治疗更成功。失败的主要原因是皮瓣插入点低于预期的腭咽接触点。
