Vlastos I M, Koudoumnakis E, Houlakis M, Nasika M, Griva M, Stylogianni E
Center of Craniofacial Anomalies, Department of Otolaryngology, Head and Neck Surgery, Aghia Sophia Children Hospital of Athens, Greece.
Int J Pediatr Otorhinolaryngol. 2009 Jul;73(7):993-7. doi: 10.1016/j.ijporl.2009.03.027. Epub 2009 May 13.
We sought to evaluate the process of care and the outcomes of cleft lip and palate operations carried by a multidisciplinary team at a centre of craniofacial anomalies with a high patients' volume.
A retrospective review of all cleft lips and/or palates cases treated in the centre from 1995 to 2007 was performed. Direct and long term complication rates, clinical, audiologic, speech intelligibility and dental arch assessments were analyzed.
A total of 530 children have been operated this period in the centre (64 isolated cleft lip closures). A detailed presentation of the outcomes is performed in relation to the various types of cleft lip and palates. The majority of parents (70%) reported very good or excellent results 2-5 years after the lip closure with the Millard technique, although those with bilateral clefts were significantly less satisfied (P<0.002). Forty-two percent of children with cleft palate and otitis media with effusion were self-improved 2-8 months after palate reconstruction and 83.3% of children treated with the two flaps palatoplasty technique had a rather high or very high intelligibility score. Muscles' retropositioning had a significant effect on intelligibility (P=0.04).
Children with cleft lips and palates have a variety of conditions and functional limitations even after the surgical correction of their problem that need to be evaluated and treated by several specialists. The treatment protocol utilized by the multidisciplinary team of our centre is efficient with a relative low percentage of complications and unfavorable results.
我们试图评估一个颅面畸形治疗中心的多学科团队开展唇腭裂手术的护理过程及治疗效果，该中心患者数量众多。
对该中心1995年至2007年治疗的所有唇裂和/或腭裂病例进行回顾性研究。分析直接和长期并发症发生率、临床、听力、语音清晰度及牙弓评估情况。
在此期间，该中心共为530名儿童实施了手术（64例单纯唇裂修复术）。针对各类唇裂和腭裂详细介绍了治疗效果。大多数家长（70%）报告称，采用米勒德技术进行唇裂修复术后2至5年效果非常好或极好，不过双侧唇裂患儿家长的满意度明显较低（P<0.002）。42%的腭裂伴中耳积液患儿在腭裂修复术后2至8个月自行好转，采用双瓣腭裂修复术治疗的患儿中，83.3%的语音清晰度得分较高或非常高。肌肉复位对语音清晰度有显著影响（P=0.04）。
唇腭裂患儿即使在手术矫正问题后仍存在多种状况和功能限制，需要由多名专家进行评估和治疗。我们中心的多学科团队采用的治疗方案效果良好，并发症和不良结果的发生率相对较低。
