Tan Wei-Qiang, Xu Jing-Hong, Yao Jian-Min
Department of Plastic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
Cleft Palate Craniofac J. 2012 Sep;49(5):635-9. doi: 10.1597/10-011. Epub 2011 Jan 20.
To introduce a surgical technique for the repair of cleft palate with the single and full-thickness Z-plasty method.
The procedure was performed from 1999 to 2006 in 34 patients with cleft palate with a median age of 6.0 years (range, 2.0 to 21 years). In these patients, in order to push the soft palate back farther, a single and full-thickness Z-plasty, designed on the soft palate across the defect, was applied to the von Langenbeck procedure. The full thickness of the soft palate was incised after the hard palate was closed by suturing the two mucoperiosteal flaps, and two Z-plasty flaps were formed. The two flaps were then transposed and closed by interrupted suturing of three layers of the palate in proper order, from nasal mucosa, levator muscle to oral mucosa. The patients were followed for 6 months to 3 years, velopharyngeal closure was examined by nasopharyngeal fiberscope and/or x-ray radiography, and a clinical speech evaluation was performed.
In all patients, no problem of flap viability was encountered and all healed well. The postoperative results were satisfactory without any complications such as dehiscence, perforation, or palatal fistula. The clinical speech evaluation was satisfactory, and the effects of the operation were stable.
The technique presented has been effective, having the advantages of palatal closure without tension and with sufficient lengthening of the soft palate.
介绍一种采用单全厚Z形成形术修复腭裂的外科技术。
1999年至2006年对34例腭裂患者实施了该手术，患者年龄中位数为6.0岁（范围2.0至21岁）。在这些患者中，为了将软腭进一步向后推移，在软腭上横跨缺损设计了单全厚Z形成形术，并应用于冯·兰根贝克手术。在通过缝合两个粘骨膜瓣关闭硬腭后，切开软腭全层，形成两个Z形成形瓣。然后将两个瓣移位，并按从鼻黏膜、提肌到口腔黏膜的顺序分层间断缝合关闭腭部。对患者进行了6个月至3年的随访，通过鼻咽纤维镜和/或X线造影检查腭咽闭合情况，并进行临床语音评估。
所有患者均未出现皮瓣存活问题，全部愈合良好。术后结果满意，未出现诸如裂开、穿孔或腭瘘等并发症。临床语音评估结果满意，手术效果稳定。
所介绍的技术是有效的，具有无张力关闭腭部且软腭充分延长的优点。
