Sie Kathleen C Y, Chen Eunice Y
Pediatric Otolaryngology-Head and Neck Surgery, Children's Hospital and Regional Medical Center, University of Washington, Seattle, WA 98105, USA.
Facial Plast Surg. 2007 May;23(2):128-39. doi: 10.1055/s-2007-979282.
Velopharyngeal closure is required for normal speech production. Incomplete velopharyngeal closure manifests as resonance disorders and nasal air escape. Management of velopharyngeal insufficiency requires a general knowledge of speech production as well as a more detailed understanding of the velopharyngeal mechanism. Comprehensive evaluation by a velopharyngeal insufficiency team includes medical assessment focusing on airway obstructive symptoms, perceptual speech analysis, and instrumental assessment, which is utilized to characterize the velopharyngeal gap. Options for intervention include speech therapy, intraoral prosthetic devices, and surgery. Surgical interventions can be categorized as palatal, palatopharyngeal, or pharyngeal procedures. The therapeutic challenge lies in achieving velopharyngeal closure during speech production while maintaining patency of the upper airway. We present our protocol for evaluation of velopharyngeal function with a focus on indications for palatoplasty and pharyngoplasty. We also discuss surgical modifications of sphincter pharyngoplasty.
正常言语产生需要腭咽闭合。腭咽闭合不全表现为共鸣障碍和鼻腔漏气。腭咽功能不全的治疗需要具备言语产生的一般知识以及对腭咽机制更详细的了解。由腭咽功能不全治疗团队进行的综合评估包括针对气道阻塞症状的医学评估、言语感知分析以及用于描述腭咽间隙的仪器评估。干预选项包括言语治疗、口腔内修复装置和手术。手术干预可分为腭部、腭咽或咽部手术。治疗挑战在于在言语产生过程中实现腭咽闭合，同时保持上呼吸道通畅。我们介绍我们评估腭咽功能的方案，重点是腭裂修复术和咽成形术的适应证。我们还讨论了括约肌咽成形术的手术改良。
