Isik Daghan, Durucu Cengiz, Isik Yasemin, Atik Bekir, Kocak Omer Faruk, Karatas Erkan, Bekerecioglu Mehmet
Department of Plastic and Reconstructive Surgery, Medicine School of Yuzuncu Yil University, Van, Turkey.
J Craniofac Surg. 2011 Jul;22(4):1203-9. doi: 10.1097/SCS.0b013e31821c0d2e.
Although cleft palate anomaly is frequent, the criterion standards in surgical treatment have not been determined yet. There are a few techniques described for cleft palate repair owing to the limited tissue in the palatal mucosa, the rigid structure of the palatal mucosa, and the limited vascularity of the hard palate. In this study, a novel cleft palate repair technique based on separating the soft palate from the hard palate as a musculomucosal flap and using it as a rotation flap has been described. The operation is evaluated individually for each anomaly because variations occur in the surgical technique according to the extension of the cleft toward the teeth in the palate. This operation was performed on a total of 28 patients (17 girls and 11 boys) aged between 1.5 and 16 years and presented to our clinic. Patients were assessed for speech analysis outcomes, tympanogram values, hearing functions, magnitude of palatal lengthening during the operation, and rate of fistulae. Statistically significant differences in values of the speech analysis and the audiometric assessment were determined between before and 6 months after surgery. Complete recovery of otitis was observed 1 month after surgery without another treatment in 9 (42.8%) of 21 patients who were detected to have serous otitis media preoperatively. Tension-free closure, lower risk of fistula, good restoration of velopharyngeal functions, ability to be performed on all types of cleft palate, ability to provide a good intraoperative exposure, and being a single stage seem to be the most important advantages of this technique.
尽管腭裂畸形很常见，但手术治疗的标准尚未确定。由于腭黏膜组织有限、腭黏膜结构僵硬以及硬腭血管供应有限，已有几种腭裂修复技术被描述。在本研究中，描述了一种基于将软腭作为肌黏膜瓣从硬腭分离并用作旋转瓣的新型腭裂修复技术。由于腭裂向腭部牙齿延伸的程度不同，手术技术会有所变化，因此针对每种畸形分别评估手术。本手术共对28例年龄在1.5至16岁之间、前来我院就诊的患者（17名女孩和11名男孩）进行。对患者进行语音分析结果、鼓室图值、听力功能、手术中腭部延长幅度以及瘘管发生率的评估。术后6个月与术前相比，语音分析和听力评估值存在统计学显著差异。术前被检测出患有浆液性中耳炎的21例患者中，9例（42.8%）在术后1个月未经其他治疗即观察到中耳炎完全恢复。无张力缝合、瘘管风险较低、腭咽功能恢复良好、适用于所有类型的腭裂、术中暴露良好以及为单阶段手术似乎是该技术最重要的优点。
