Atik Bekir, Bekerecioglu Mehmet, Tan Onder, Etlik Omer, Davran Ramazan, Arslan Halil
Department of Plastic and Reconstructive Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey.
J Craniofac Surg. 2008 May;19(3):566-72. doi: 10.1097/SCS.0b013e31816ae746.
Velopharyngeal insufficiency (VPI) expresses the structural and neuromuscular disorder of soft palate and pharyngeal walls inhibiting the normal functions of velopharyngeal (VP) sphincter mechanism. In this study, efficacy of dynamic magnetic resonance imaging in the diagnosis of VPI is investigated.
A total of 32 cases, 16 controls and 16 cleft palates, were included in this study. T1 fast spin echo-weighted imaging during rest, dynamic investigations with True-fast imaging with steady-state precession sequence during /sss/ and /mmm/ phonations were performed.
During /sss/ phonation, complete closure was observed in the control group, whereas mean VP opening was 4.11 cm2 preoperatively and 0.21 cm2 postoperatively in the cleft palate group. In the postoperative period, only 3 patients did not have complete closure. In the second operations, performed 6 months later, only muscle repair was done. All 3 had complete closure.
In cleft palate cases with delayed diagnosis, appropriate application of muscle repair will be sufficient for anatomic repair of VPI without any extra procedures. In addition, dynamic magnetic resonance imaging is an objective, noninvasive, reliable, and effective modality that may be used in the diagnosis and treatment of VPI without any extra investigations.
腭咽闭合不全（VPI）表现为软腭和咽壁的结构及神经肌肉紊乱，抑制了腭咽（VP）括约肌机制的正常功能。本研究探讨动态磁共振成像在VPI诊断中的有效性。
本研究共纳入32例患者，其中16例为对照组，16例为腭裂患者。在静息状态下进行T1快速自旋回波加权成像，在发/sss/和/mmm/音时采用稳态进动快速成像序列进行动态检查。
在发/sss/音时，对照组观察到完全闭合，而腭裂组术前平均VP开口为4.11平方厘米，术后为0.21平方厘米。术后，只有3例患者未完全闭合。在6个月后进行的二次手术中，仅进行了肌肉修复。所有3例均实现了完全闭合。
在诊断延迟的腭裂病例中，适当应用肌肉修复足以对VPI进行解剖修复，无需任何额外手术。此外，动态磁共振成像为一种客观、无创、可靠且有效的方法，可用于VPI的诊断和治疗，无需任何额外检查。
