Denadai Rafael, Sabbag Anelise, Amaral Cassio Eduardo Raposo, Pereira Filho João Carlos, Nagae Mirian Hideko, Amaral Cesar Augusto Raposo
Hospital SOBRAPAR, Instituto de Cirurgia Plástica Craniofacial, Campinas, SP, Brazil.
Hospital SOBRAPAR, Instituto de Cirurgia Plástica Craniofacial, Campinas, SP, Brazil; Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Desenvolvimento Humano e Reabilitação, Campinas, SP, Brazil.
Braz J Otorhinolaryngol. 2018 Nov-Dec;84(6):697-707. doi: 10.1016/j.bjorl.2017.08.006. Epub 2017 Sep 12.
The interpretation of the speech results obtained with the buccinator myomucosal flap in the treatment of velopharyngeal insufficiency in patients with cleft palate has been limited by the restriction in the number of patients and the time of postoperative follow-up.
To evaluate the effect of the buccinator myomucosal flap on speech hypernasality in the treatment of patients with cleft palate and velopharyngeal insufficiency.
Patients with repaired cleft palate (± lip) who were submitted to surgical correction of velopharyngeal insufficiency using the bilateral buccinator myomucosal flap were assessed. Hypernasality (scores 0 [absent], 1 [mild], 2 [moderate], or 3 [severe]) was analyzed by three evaluators by measuring the audiovisual records collected in early and late preoperative and postoperative periods (3 and 12 months, respectively). The values were considered significant for a 95% Confidence Interval (p<0.05).
Thirty-seven patients with cleft palate (± lip) showing moderate (16.2%) or severe (83.8%) hypernasality in the preoperative period were included. Analyses of the late postoperative period showed that hypernasality (0.5±0.7) was significantly (p<0.05) lower than the hypernasality of the preoperative and recent postoperative periods (2.8±0.4 and 1.7±0.9, respectively).
The buccinator myomucosal flap is effective in reducing/eliminating hypernasality in patients with cleft palate (± lip) and velopharyngeal insufficiency.
腭咽闭合不全患者采用颊肌黏膜瓣治疗所获得的语音结果的解读，因患者数量及术后随访时间的限制而受到制约。
评估颊肌黏膜瓣治疗腭裂及腭咽闭合不全患者语音鼻音过重的效果。
对采用双侧颊肌黏膜瓣进行腭咽闭合不全手术矫正的腭裂（±唇裂）修复患者进行评估。由三名评估者通过测量术前早期、术后早期（分别为3个月和12个月）及术后晚期收集的视听记录，分析鼻音过重情况（评分0[无]、1[轻度]、2[中度]或3[重度]）。95%置信区间（p<0.05）时，这些值被认为具有统计学意义。
纳入37例术前存在中度（16.2%）或重度（83.8%）鼻音过重的腭裂（±唇裂）患者。术后晚期分析显示，鼻音过重情况（0.5±0.7）显著低于术前及术后近期（分别为2.8±0.4和1.7±0.9）（p<0.05）。
颊肌黏膜瓣在减少/消除腭裂（±唇裂）及腭咽闭合不全患者的鼻音过重方面有效。
