Yu Jenny L, Nguyen Dennis C, Chaiyasate Kongkrit, Gangopadhyay Noopur, Sachanandani Neil, Woo Albert S
*Division of Plastic and Reconstructive Surgery, Washington University School of Medicine in St Louis, St Louis, MO †Plastic and Reconstructive Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, MI ‡Department of Plastic Surgery, The Ohio State University, Columbus, OH §Department of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, RI.
J Craniofac Surg. 2017 Mar;28(2):343-346. doi: 10.1097/SCS.0000000000003273.
The double-opposing Z-plasty is an effective method of repairing the cleft palate due to its reorientation of the palatal musculature and lengthening of the soft palate. A technique for lengthening the palate with a single oral Z-plasty has also been described. The authors hypothesize that these 2 techniques have equivalent effects on palate length.
A cadaver study was performed. Ten fresh adult cadaver heads were used.All palates were divided in the midline. In 5 specimens, a modified double-opposing Z-plasty technique was used; 5 other specimens underwent an oral Z-plasty with a straight-line repair of the nasal mucosa. In both groups, the levator veli palatini muscles were separately dissected and reapproximated with an intravelar veloplasty. The velar length, defined in this study as the distance from the posterior nasal spine to the tip of uvula, was measured before and after the surgical procedure.
The double-opposing Z-plasty produced a mean increase of 1.0 ± 0.6 cm in velar length (P = 0.023). The single Z-plasty repair resulted in a mean gain of 1.1 ± 0.3 cm (P = 0.001). There was no difference in change in palate length between the 2 procedures (P = 0.941), and no difference in the percentage of soft palate lengthening (24% vs 29%, respectively; P = 0.565).
A single oral Z -plasty provides palatal lengthening equivalent to that of a double-opposing Z-plasty procedure.
双反向Z成形术是修复腭裂的一种有效方法，因为它能使腭部肌肉重新定向并延长软腭。也有文献描述了一种用单一口腔Z成形术延长腭部的技术。作者推测这两种技术对腭部长度的影响相当。
进行了一项尸体研究。使用了10个新鲜的成年尸体头部。所有腭部均在中线处切开。在5个标本中，采用了改良的双反向Z成形术技术；另外5个标本进行了口腔Z成形术并对鼻黏膜进行直线修复。在两组中，分别解剖腭帆提肌并通过腭内腭成形术使其重新对合。本研究中定义的腭部长度为从鼻后棘到悬雍垂尖端的距离，在手术前后进行测量。
双反向Z成形术使腭部长度平均增加了1.0±0.6 cm（P = 0.023）。单一Z成形术修复使腭部长度平均增加了1.1±0.3 cm（P = 0.001）。两种手术在腭部长度变化上没有差异（P = 0.941），在软腭延长百分比上也没有差异（分别为24%和29%；P = 0.565）。
单一口腔Z成形术提供的腭部延长效果与双反向Z成形术相当。
