Gu Meizhen, Huang Xiuchang, Xu Hongming, Chen Fang, Jiang Yugang, Li Xiaoyan
Department of Otorhinolaryngology-Head and Neck Surgery, Children's Hospital of Shanghai Jiaotong University.
School of Mechanical Engineering, Shanghai Jiao Tong University.
Medicine (Baltimore). 2019 Nov;98(47):e17958. doi: 10.1097/MD.0000000000017958.
clinical results of A STROBE-compliant retrospective study OBJECTIVE:: To achieving adequate pharyngeal closure and improve the pharyngeal function by a modified two-flap palatoplasty.
Excessive tension in soft palate is the main factor causing the dysphonia after cleft palate. The tension-free suture of the soft palate is the key to achieving adequate pharyngeal closure. In this paper, a modified two-flap palatoplasty improved the pharyngeal function METHODS:: From August 2016 to December 2017, 20 patients with cleft palate were treated with a modified two-flap palatoplasty of the posterolateral symmetrical mucosal relaxation incision. The mucosal relaxation incision was performed on both posterolateral sides of the soft palate.
All cases had good healing of mucosal flap and the palate. All patients underwent endoscopic examination at 6 months after operation. The postoperative results were satisfactory, with no complications. Twelve patients had bilateral exudative otitis media before operation, 4 patients returned to normal postoperatively, and 8 patients underwent bilateral tympanic membrane catheterization; 2 patients had abnormal function of bilateral eustachian tube before operation and returned to normal postoperatively; 3 patients had unilateral exudative otitis media before operation, and all of them returned to normal; the acoustic impedance test was normal in 3 children before operation. Most children begin to learn to speak, parents are satisfied with their pronunciation, and 3 children are in speech rehabilitation due to unclear pronunciation.
We propose a technique to improve the function of the velopharyngeal closure which effectively reduces the incidence of pharyngeal insufficiency and occurrence of operative correction of pharyngeal closure dysfunction. The modifed two-flap palatoplasty with posterior lateral symmetric mucosal relaxation incision is beneficial for better velopharyngeal closure.
一项符合STROBE标准的回顾性研究的临床结果
通过改良双瓣腭裂修复术实现充分的咽闭合并改善咽功能。
软腭张力过大是腭裂术后发声障碍的主要因素。软腭无张力缝合是实现充分咽闭合的关键。本文介绍一种改良双瓣腭裂修复术改善咽功能的方法。
2016年8月至2017年12月，对20例腭裂患者采用改良双瓣腭裂修复术，即后外侧对称黏膜松弛切口。在软腭两侧后外侧做黏膜松弛切口。
所有病例黏膜瓣和腭部愈合良好。所有患者术后6个月接受内镜检查。术后效果满意，无并发症。术前12例患者双侧渗出性中耳炎，术后4例恢复正常，8例患者行双侧鼓膜置管；术前2例患者双侧咽鼓管功能异常，术后恢复正常；术前3例患者单侧渗出性中耳炎，均恢复正常；术前3例儿童声阻抗测试正常。多数儿童开始学说话，家长对其发音满意，3例儿童因发音不清正在进行言语康复训练。
我们提出一种改善腭咽闭合功能的技术，可有效降低咽闭合不全的发生率及咽闭合功能障碍手术矫正的发生率。采用后外侧对称黏膜松弛切口的改良双瓣腭裂修复术有利于更好地实现腭咽闭合。
