Pet Mitchell A, Marty-Grames Lynn, Blount-Stahl Mary, Saltzman Babette S, Molter David W, Woo Albert S
Cleft Palate Craniofac J. 2015 Jan;52(1):12-22. doi: 10.1597/13-033.
We investigated how Furlow palatoplasty changes velopharyngeal morphology and speech characteristics, as well as how the anatomical and clinical results might be related. We hypothesized that Furlow palatoplasty would result in measurable velar elongation, tightening of the genu angle, and retropositioning of the levator sling and that the achievement of these modifications might be associated with clinical speech improvement.
Retrospective analysis of preoperative and postoperative videofluoroscopic and speech data.
Tertiary care center.
PATIENTS/PARTICIPANTS: A total of 29 patients with velopharyngeal insufficiency in the setting of previous cleft palate repair or submucous cleft palate.
Furlow palatoplasty for treatment of velopharyngeal insufficiency.
Lateral videofluoroscopy and perceptual speech examination were conducted preoperatively and postoperatively in order to measure velopharyngeal dimensions and speech quality. We describe anatomical and speech changes associated with the Furlow palatoplasty and undertake an exploratory analysis of the relationship between surgical changes to the velopharynx and clinical outcomes.
Furlow palatoplasty results in significant velar elongation, increased acuity of the genu angle, and retropositioning of the levator sling. Postoperative speech improvement was identified on the three subscales of resonance, nasal emission, and stops/plosives. Speech improvement and the absence of need for reoperation were most consistently associated with tightening of the genu angle.
Furlow palatoplasty lengthens the palate, while both tightening and retropositioning the levator sling. These changes reflect transverse recruitment of lateral velar tissues, along with transverse tightening and anterior release of the muscle fibers, respectively. Levator tightening is most consistently associated with improved speech outcomes.
我们研究了Furlow腭成形术如何改变腭咽形态和语音特征，以及解剖学和临床结果之间可能存在的关联。我们假设Furlow腭成形术会导致软腭可测量的延长、膝状角变紧以及提肌吊带后移，并且这些改变的实现可能与临床语音改善相关。
对术前和术后的视频荧光镜检查及语音数据进行回顾性分析。
三级医疗中心。
患者/参与者：共有29例曾接受腭裂修复术或黏膜下腭裂修复术且存在腭咽功能不全的患者。
采用Furlow腭成形术治疗腭咽功能不全。
术前和术后进行侧位视频荧光镜检查和语音感知检查，以测量腭咽尺寸和语音质量。我们描述与Furlow腭成形术相关的解剖学和语音变化，并对腭咽部手术变化与临床结果之间的关系进行探索性分析。
Furlow腭成形术可导致软腭明显延长、膝状角变尖锐以及提肌吊带后移。在共鸣、鼻漏气和塞音/爆破音这三个子量表上均发现术后语音有所改善。语音改善且无需再次手术与膝状角变紧最为相关。
Furlow腭成形术可延长腭部，同时收紧并后移提肌吊带。这些变化分别反映了外侧软腭组织的横向募集，以及肌肉纤维的横向收紧和前部松解。提肌收紧与语音改善结果最为相关。
