Abdel-Aziz Mosaad, El-Hoshy Hassan, Naguib Nader, Reda Ramez
Department of Otolaryngology, Faculty of Medicine, Cairo University, Egypt.
Int J Pediatr Otorhinolaryngol. 2012 Jan;76(1):52-6. doi: 10.1016/j.ijporl.2011.09.030. Epub 2011 Oct 20.
Fistula of the palate is a common complication of palatoplasty, it leads to nasal regurgitation of fluids and hypernasality of speech. Its treatment is technically difficult due to paucity and fibrosis of palatal tissues. The aim of this study was to evaluate the efficacy of closure of soft palate fistula by using Furlow double opposing Z-palatoplasty.
Nineteen patients were subjected for repair of their soft palate fistulas using Furlow Z-plasty. Pre and postoperative speech analysis using auditory perceptual assessment, measurement of nasalance score using nasometric assessment, and measurement of velar movement using flexible nasopharyngoscopy were done.
All cases showed complete closure of their fistulas at first attempt, with no operative or postoperative complications. Recurrence was not recorded in any case after a follow up period of at least 12 months. Significant improvement of speech quality and nasalance score was achieved. Flexible nasopharyngoscopy showed postoperative increase in velar movement which was not significant relative to the preoperative records.
Treatment of soft palate fistula by using Furlow technique is an effective method as a primary treatment with a high success rate and a good functional outcome.
腭瘘是腭裂修复术后的常见并发症,可导致液体经鼻腔反流和语音鼻音过重。由于腭部组织稀少且纤维化,其治疗在技术上具有挑战性。本研究的目的是评估使用弗洛(Furlow)双反向Z形腭成形术关闭软腭瘘的疗效。
19例患者采用弗洛(Furlow)Z形成形术修复软腭瘘。术前和术后进行语音分析,采用听觉感知评估,使用鼻音计评估测量鼻漏气分数,并使用软性鼻咽喉镜测量腭运动。
所有病例首次尝试时瘘口均完全闭合,无手术或术后并发症。至少随访12个月后,未记录到任何复发病例。语音质量和鼻漏气分数有显著改善。软性鼻咽喉镜检查显示术后腭运动增加,但与术前记录相比无显著差异。
使用弗洛(Furlow)技术治疗软腭瘘是一种有效的主要治疗方法,成功率高,功能效果良好。