Boston, Mass.; and Syracuse, N.Y. From the Department of Plastic and Oral Surgery and the Craniofacial Centre, Children's Hospital and Harvard Medical School, and the Central New York Cleft and Craniofacial Center, Upstate Medical University Hospital.
Plast Reconstr Surg. 2010 Jan;125(1):290-298. doi: 10.1097/PRS.0b013e3181c2a6c1.
Velopharyngeal insufficiency occurs in 5 to 20 percent of children following repair of a cleft palate. The pharyngeal flap is the traditional secondary procedure for correcting velopharyngeal insufficiency; however, because of perceived complications, alternative techniques have become popular. The authors' purpose was to assess a single surgeon's long-term experience with a tailored superiorly based pharyngeal flap to correct velopharyngeal insufficiency in nonsyndromic patients with a repaired cleft palate.
The authors reviewed the records of all children who underwent a pharyngeal flap performed by the senior author (J.B.M.) between 1981 and 2008. The authors evaluated age of repair, perceptual speech outcome, need for a secondary operation, and complications. Success was defined as normal or borderline sufficient velopharyngeal function. Failure was defined as borderline insufficiency or severe velopharyngeal insufficiency with recommendation for another procedure.
The authors identified 104 nonsyndromic patients who required a pharyngeal flap following cleft palate repair. The mean age at pharyngeal flap surgery was 8.6 +/- 4.9 years. Postoperative speech results were available for 79 patients. Operative success with normal or borderline sufficient velopharyngeal function was achieved in 77 patients (97 percent). Obstructive sleep apnea was documented in two patients.
The tailored superiorly based pharyngeal flap is highly successful in correcting velopharyngeal insufficiency, with a low risk of complication, in nonsyndromic patients with repaired cleft palate.
腭裂修复术后，5%至 20%的儿童会出现咽鼓管功能不全。咽成形术是传统的治疗咽鼓管功能不全的二级手术；然而，由于存在并发症，替代技术变得流行起来。作者的目的是评估一位外科医生使用改良的上提式咽成形术治疗非综合征性腭裂修复术后患者咽鼓管功能不全的长期经验。
作者回顾了所有由高级作者（J.B.M.）在 1981 年至 2008 年间进行咽成形术的患者的病历。作者评估了修复年龄、感知性语音结果、是否需要二次手术以及并发症。成功定义为正常或边缘性足够的咽鼓管功能，失败定义为边缘性不足或严重的咽鼓管功能不全，需要推荐进行另一种手术。
作者确定了 104 例非综合征性患者，这些患者在腭裂修复后需要进行咽成形术。咽成形术的平均年龄为 8.6 ± 4.9 岁。79 例患者的术后语音结果可用。77 例患者（97%）手术成功，表现为正常或边缘性足够的咽鼓管功能。两名患者诊断为阻塞性睡眠呼吸暂停。
改良的上提式咽成形术在治疗非综合征性腭裂修复术后患者的咽鼓管功能不全方面非常成功，并发症风险低。
