Indianapolis, Ind.; Iowa City, Iowa; and New York, N.Y. From the Division of Plastic Surgery, Riley Hospital for Children, Indiana University Medical Center; the Division of Plastic and Reconstructive Surgery, Department of Surgery, and Department of Otolaryngology, University of Iowa Hospitals and Clinics; and the Department of Otolaryngology and the Institute of Reconstructive Plastic Surgery, New York University Medical Center.
Plast Reconstr Surg. 2010 Jan;125(1):282-289. doi: 10.1097/PRS.0b013e3181c2a43a.
During cleft palate repair, levator sling palatoplasty with tensor veli palatini tendon transection significantly improves speech results. However, the procedure may pose a risk to eustachian tube function. This study assesses the impact of three types of palatoplasty techniques on eustachian tube function: no tensor transection, tensor transection alone, and a new addition to the palatoplasty technique, tensor tenopexy.
A retrospective review was conducted of all patients undergoing cleft palate repair at two institutions between 1997 and 2001. Three cleft palate repair groups were studied: no tensor transection (n = 64), tensor transection alone (n = 31), and tensor tenopexy (n = 52). The percentages of patients requiring myringotomy tubes at each year of age were compared among the three groups.
By 7 years of age, there was a significantly decreased need for myringotomy tubes in patients who underwent no tensor transection compared with patients who underwent tensor transection alone (38 percent versus 61 percent, respectively; p = 0.05), as well as for patients who underwent tensor tenopexy compared with patients who underwent tensor veli palatini tendon transection (23 percent versus 61 percent, respectively; p < 0.001). Also, by the age of 7, there was a trend toward a decreased need for myringotomy tubes in patients who underwent tensor tenopexy compared with patients who underwent no tensor transection (23 percent versus 38 percent, respectively; p = 0.11).
No tensor transection and tensor tenopexy significantly decrease the need for myringotomy tubes compared with tensor transection alone. There is a small decrease in the need for myringotomy tubes when comparing tensor tenopexy with no tensor transection.
在腭裂修复术中，切断腭帆提肌与剪断腭帆张肌腱的悬雍垂肌瓣转移术可显著改善语音效果。然而，该手术可能会对咽鼓管功能造成影响。本研究评估了三种腭裂修复技术对咽鼓管功能的影响：不切断腭帆张肌、仅切断腭帆张肌和腭裂修复技术的新附加术式——腭帆张肌腱固定术。
对 1997 年至 2001 年间在两家机构接受腭裂修复术的所有患者进行了回顾性研究。研究了三组腭裂修复患者：不切断腭帆张肌（n = 64）、仅切断腭帆张肌（n = 31）和腭帆张肌腱固定术（n = 52）。比较了三组患者在各年龄段需要鼓膜切开术的比例。
7 岁时，与仅切断腭帆张肌的患者相比，不切断腭帆张肌的患者需要鼓膜切开术的比例明显降低（分别为 38%和 61%，p = 0.05），与切断腭帆张肌腱的患者相比，接受腭帆张肌腱固定术的患者需要鼓膜切开术的比例也明显降低（分别为 23%和 61%，p < 0.001）。此外，到 7 岁时，与不切断腭帆张肌的患者相比，接受腭帆张肌腱固定术的患者需要鼓膜切开术的比例也呈下降趋势（分别为 23%和 38%，p = 0.11）。
与单独切断腭帆张肌相比，不切断腭帆张肌和腭帆张肌腱固定术可显著降低需要鼓膜切开术的比例。与不切断腭帆张肌相比，腭帆张肌腱固定术可使鼓膜切开术的需求略有减少。
