Hassani Mohammad-Esmaiil, Latifi Noor-Ahmad, Karimi Hamid, Khakzad Mohammad
Faculty of Medicine, Iran University of Medical Sciences, Tehran.
Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran.
J Craniofac Surg. 2018 Sep;29(6):1619-1624. doi: 10.1097/SCS.0000000000004612.
Velopharyngeal insufficiency is one of the most frequent complications after cleft palate repair.
To evaluate the results and complications of unilateral Buccinator flap (BMF) in velopharyngeal insufficiency.
During 4 years the authors performed unilateral BMF in all short palates. Age, sex, demographic data, length of palate, cause of short palate, nasopharyngoscopy and videofluroscopy results, hyper nasality, nasal escape, nasal emission, nasal fluid leak, speech evaluation and results, outcome and complications of the treatment were surveyed before surgery and in 1, 3, 6 months after treatment.
The authors had 43 patients, 29 below 8 years old and 14 adults. Velopharyngeal gap was between 10 and 27 mm, mean 21 mm. Buccinator flap were measuring 15 to 19 mm in width and 32 to 56 mm in length. The operation time was 80 to 100 minutes, mean 86 minutes.Nasal emission, nasal escape, and nasal leak were treated in all patients.Hyper nasality was completely improved in all of the patients below 8 years old (29 patients) and in 10 patients of the adults (totally 39 patients, 90.6%). And it was improved significantly in other 4 patients (9.4%). The speech evaluation reported between 70% and 86% improvements.The lengthening of the palate was between 12 and 19 mm, mean 17 mm.The satisfaction of the patients was as 0% poor, 2.3% fair, 72.1% good, and 25.6% excellent.
Unilateral BMF is reliable, promising, and safe flap for lengthening of short palate and it can lengthen the palate up to 19 mm. The time of surgery is very short compared with other methods. It is an anatomical treatment versus pharyngeal flap which is not an anatomical one. Speech improvement will achieve in 70% to 86% patients.
腭咽闭合不全是腭裂修复术后最常见的并发症之一。
评估单侧颊肌瓣（BMF）治疗腭咽闭合不全的效果及并发症。
在4年时间里，作者对所有短腭患者实施了单侧BMF手术。在手术前以及治疗后的1个月、3个月和6个月，对患者的年龄、性别、人口统计学数据、腭部长度、短腭原因、鼻咽镜检查和电视荧光透视检查结果、鼻音过重、鼻腔漏气、鼻漏、语音评估及结果、治疗的结局和并发症进行了调查。
作者共治疗了43例患者，其中29例年龄在8岁以下，14例为成年人。腭咽间隙在10至27毫米之间，平均为21毫米。颊肌瓣宽度为15至19毫米，长度为32至56毫米。手术时间为80至100分钟，平均86分钟。所有患者的鼻漏、鼻腔漏气和鼻溢均得到治疗。所有8岁以下患者（29例）及10例成年患者（共39例，90.6%）的鼻音过重完全改善，另外4例患者（9.4%）有显著改善。语音评估显示改善率在70%至86%之间。腭部延长在12至19毫米之间，平均17毫米。患者满意度为：0%差，2.3%一般，72.1%良好，25.6%优秀。
单侧BMF是一种可靠、有前景且安全的用于延长短腭的皮瓣，它可使腭部延长达19毫米。与其他方法相比，手术时间非常短。这是一种解剖学治疗方法，而咽瓣则不是解剖学方法。70%至86%的患者语音会得到改善。
