Lu Yong, Shi Bing, Zheng Qian, Hu Qinggang, Wang Zhiyong
Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital, Medical School of Nanjing University, No. 30 Zhong Yang's Road, Xuan Wu, Nanjing 210008, Jiangsu Province, China.
Br J Oral Maxillofac Surg. 2010 Dec;48(8):637-40. doi: 10.1016/j.bjoms.2009.10.018. Epub 2009 Nov 27.
The purpose of this study was to find out the incidence of palatal fistula and study the factors that influence its development after palatoplasty with repositioning of the levator veli palatini. We retrospectively reviewed 176 consecutive repairs of cleft palates during a 2-year period (2004-2006). The age of the patients at the time of repair ranged from 12 to 30 months (mode 17 months). All the palatoplasties were done either by a senior surgeon or a resident surgeon. The chi square test was used to assess whether the development of postoperative fistulas was influenced by sex, extent of cleft (as estimated by the Veau classification), age at repair, and operating surgeon. There were 12 palatal fistulas (7%), 8 of which were at the junction of the hard and soft palate, 3 in the hard palate, and 1 in the soft palate. There was no evidence to suggest that sex or age were associated with their development. Patients whose clefts had been treated by the senior surgeon had fewer fistulas (2/82, 2%) than those by the resident surgeon (10/94, 11%) (p=0.04). The incidences of palatal fistulas in patients with clefts of the hard and soft cleft palate (7/44, 21%), and bilateral cleft lip or palate (2/21,10%), were significantly higher than those in patients with cleft soft palate (1/37, 3%), and unilateral cleft lip or palate (2/74, 3%) (p=0.03). Our results show that palatal fistula after repair is related mainly to the extent of the cleft and the experience of the operating surgeon.
本研究的目的是查明腭瘘的发生率，并研究在腭帆提肌重新定位的腭裂修复术后影响其发生发展的因素。我们回顾性分析了2004年至2006年这两年间连续进行的176例腭裂修复手术。修复时患者的年龄在12至30个月之间（平均17个月）。所有腭裂修复手术均由资深外科医生或住院医生完成。采用卡方检验来评估术后瘘管的发生是否受性别、腭裂程度（根据韦氏分类法评估）、修复时的年龄以及手术医生的影响。共有12例腭瘘（7%），其中8例位于硬腭与软腭交界处，3例在硬腭，1例在软腭。没有证据表明性别或年龄与腭瘘的发生有关。由资深外科医生治疗腭裂的患者发生瘘管的比例（2/82，2%）低于住院医生治疗的患者（10/94，11%）（p = 0.04）。硬软腭裂患者（7/44，21%）和双侧唇腭裂患者（2/21，10%）的腭瘘发生率显著高于软腭裂患者（1/37，3%）和单侧唇腭裂患者（2/74，3%）（p = 0.03）。我们的结果表明，修复术后的腭瘘主要与腭裂程度和手术医生的经验有关。
