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舌系带修复术:Z 成形术与单纯松解术对比

Tongue-tie Repair: Z-Plasty Vs Simple Release.

作者信息

Yousefi Jamshid, Tabrizian Namini Fariba, Raisolsadat Seyed Mohammad Ali, Gillies Rowan, Ashkezari Azar, Meara John G

机构信息

Department of Pediatric Surgery, 22 Bahman Hospital, Islamic Azad University of Mashhad, Mashhad, Iran.

Clinical Fellow, Program in Global Surgery and Social Change, Boston Children's Hospital, Harvard Medical School, Boston, USA.

出版信息

Iran J Otorhinolaryngol. 2015 Mar;27(79):127-35.

Abstract

INTRODUCTION

Ankyloglossia is a congenital anomaly in which the lingual frenulum is unusually short and thick, thus decreasing tongue mobility. In the context of the newborn or young infant it is a subject of ongoing controversy within and between medical specialties. The controversy involves not only the definition but also the management of this anomaly. A tight lingual frenulum is considered a minor malformation by some investigators. Usual treatments for ankyloglossia include speech therapy, as well as simple frenulotomy and frenuloplasty. The aim of this study was to compare the latter two methods with respect to postoperative results and complications.

MATERIALS AND METHODS

A total of 50 patients referred for surgical care were randomly assigned into two groups: simple release (frenulotomy ) or Z-plasty (frenuloplasty), and underwent a pre-surgical assessment. After 3 months, patients were followed with a scheduled interview and questionnaire comparing the outcomes of the two methods. The data were analyzed using SPSS version 18.

RESULTS

Surgery had a significant effect on all variables measured in our study (P<0.05). Z-plasty had a greater effect on articulation, breast pain, tongue movement and parent satisfaction than simple release (P<0.05). Z-plasty and simple release had the same effect on breast feeding, latching, and sucking.

CONCLUSION

Z-plasty is the preferred surgical method to address tongue-tie due to a greater improvement in mother's breast pain, pronunciation and speech, tongue movement, and parental satisfaction.

摘要

引言

舌系带过短是一种先天性异常,其中舌系带异常短且厚,从而降低了舌头的活动度。在新生儿或幼儿的背景下,这在医学专业内部和之间一直是一个有争议的话题。争议不仅涉及该异常的定义,还涉及管理。一些研究人员认为紧密的舌系带是一种轻微畸形。舌系带过短的常见治疗方法包括言语治疗,以及简单的系带切开术和系带成形术。本研究的目的是比较后两种方法在术后结果和并发症方面的差异。

材料与方法

总共50名接受手术治疗的患者被随机分为两组:简单松解(系带切开术)或Z成形术(系带成形术),并进行术前评估。3个月后,通过定期访谈和问卷对患者进行随访,比较两种方法的结果。使用SPSS 18版对数据进行分析。

结果

手术对我们研究中测量的所有变量都有显著影响(P<0.05)。与简单松解相比,Z成形术对发音、乳房疼痛、舌头运动和家长满意度的影响更大(P<0.05)。Z成形术和简单松解在母乳喂养、含接和吸吮方面的效果相同。

结论

由于在母亲的乳房疼痛、发音和言语、舌头运动以及家长满意度方面有更大改善,Z成形术是治疗舌系带过短的首选手术方法。

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