Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Deagu, Republic of Korea.
Department of Plastic and Reconstructive Surgery, School of Medicine, Kyungpook National University, Deagu, Republic of Korea.
J Craniomaxillofac Surg. 2018 Jun;46(6):947-952. doi: 10.1016/j.jcms.2018.02.015. Epub 2018 Mar 29.
This study investigated the effects of Furlow palatoplasty on children with submucous cleft palate (SMCP) and identified surgical indications by comparing SMCP and control patients. Twenty-three SMCP children (average age 28.9 months) who were nonsyndromic and underwent surgery between April 2010 and December 2016 were included. Facial computed tomography (CT) was performed preoperatively and at least 1 year postoperatively after a language test. Facial CT measurements were taken for 140 children aged 0-6 years without deformities (control group). Later surgery was associated with more severe nasality. In the coronal view, the difference in the maxillary tuberosity before and after surgery was 3.8 mm (p < 0.05). The height and width of the palatal arch (HNP and WNP) were well maintained (p > 0.05), whereas the angle of the levator veli palatini muscle (ALM) increased (p < 0.05). The nasopharynx was close to normal postoperatively. The distance between the medial pterygoid plates, the HNP, and the WNP were larger in SMCP patients preoperatively (p < 0.05), but these differences disappeared after surgery (p > 0.05). The ALM in SMCP patients was narrower preoperatively, but became flatter postoperatively (p < 0.05), indicating the repositioning of the levator muscle, with improvement of the velopharyngeal function. Furlow palatoplasty is indicated if the HNP and WNP values are larger, and the ALM value is less, in patients with SMCP than in those without.
本研究通过比较黏膜下裂腭裂（SMCP）患者和对照组患者，探讨了 Furlow 腭裂修补术对儿童 SMCP 的影响，并确定了手术适应证。纳入了 23 名非综合征性 SMCP 儿童（平均年龄 28.9 个月），他们在 2010 年 4 月至 2016 年 12 月期间接受了手术。所有患儿均在术前和术后至少 1 年进行语言测试时行面部计算机断层扫描（CT）检查。选择了 140 名年龄在 0-6 岁、无畸形的儿童（对照组）作为对照。后期手术与更严重的鼻音有关。冠状位测量上颌结节术前、术后差值为 3.8mm（p<0.05）。腭弓高度（HNP）和宽度（WNP）保持良好（p>0.05），而腭帆张肌角（ALM）增大（p<0.05）。术后鼻咽部接近正常。SMCP 患者术前翼内板间距离、HNP 和 WNP 较大（p<0.05），但术后差异消失（p>0.05）。SMCP 患者的 ALM 术前较窄，但术后变平（p<0.05），提示提肌重新定位，腭咽功能改善。Furlow 腭裂修补术适用于 HNP 和 WNP 值较大，ALM 值较小的 SMCP 患者。
