[腭裂患者的形态学分类及腭咽功能分析]
[Morphological classification and velopharyngeal function analysis of submucous cleft palate patients].
作者信息
Heng Yin, Chunli Guo, Bing Shi, Yang Li, Jingtao Li
机构信息
State Key Laboratory of Oral Diseases, Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
出版信息
Hua Xi Kou Qiang Yi Xue Za Zhi. 2016 Oct 1;34(5):488-492. doi: 10.7518/hxkq.2016.05.011.
OBJECTIVE
To enhance the accuracy in diagnosis and management of submucous cleft palate via a thorough analysis of its anatomical and functional details.
METHODS
Two hundred seventy-six submucous cleft palate cases from 2008 to 2014 were retrospectively investigated. Subgroup analysis were performed on the basis of preoperative velopharyngeal function, palatal morphology, cleft lip concurrence, and patient motives for treatment.
RESULTS
Among the included cases, 96 (34.78%) were presented as velopharyngeal competence (VPC), 151 (54.71%) as velopharyngeal insufficiency (VPI), and 29 (10.51%) as marginal VPI (MVPI). Eighty cases (28.99%) also demonstrated cleft lip deformity, and 196 cases (71.01%) were merely submucous cleft palate. Compared with patients with submucous cleft palate only, those with cleft lips exhibited higher rates of complete velopharyngeal closure. The pathological spectrum of submucous cleft palate varied significantly. Only 103 (37.32%) cases met all the three diagnostic criteria proposed by Calnan.
CONCLUSIONS
Given that the velopharyngeal closure rate varies among the subgroups, the factors analyzed in this study should be considered in the personalized manage-ment of submucous cleft palate.
目的
通过对黏膜下腭裂的解剖和功能细节进行全面分析，提高其诊断和治疗的准确性。
方法
回顾性研究2008年至2014年的276例黏膜下腭裂病例。根据术前腭咽功能、腭部形态、唇裂并发情况及患者治疗动机进行亚组分析。
结果
纳入病例中，96例（34.78%）表现为腭咽闭合功能正常（VPC），151例（54.71%）为腭咽闭合功能不全（VPI），29例（10.51%）为边缘性腭咽闭合功能不全（MVPI）。80例（28.99%）还伴有唇裂畸形，196例（71.01%）仅为黏膜下腭裂。与仅患有黏膜下腭裂的患者相比，伴有唇裂的患者腭咽完全闭合率更高。黏膜下腭裂的病理谱差异显著。仅103例（37.32%）符合卡尔南提出的所有三项诊断标准。
结论
鉴于各亚组的腭咽闭合率不同，在黏膜下腭裂的个体化治疗中应考虑本研究分析的因素。
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