Yin Heng, Huang Han-Yao, Guo Chun-Li, Wang Xi, Shi Bing, Li Jing-Tao
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2020 Feb 1;38(1):48-53. doi: 10.7518/hxkq.2020.01.009.
To demonstrate the regularity of velopharyngeal function recovery after primary cleft palatoplasty and its correlation with different surgical procedures, ages, cleft types, and follow-up times.
Patients with cleft palate under 5 years old who had more than two follow-up records were included in this study, and consecutive evaluations of postoperative velopharyngeal function were performed. Univariate and multivariate logistic regression analysis were used to reveal the regularity of postoperative velopharyngeal function and the possible influencing factors.
A total of 165 patients were included. Inconsistent functions of the velopharyngeal closure were observed in 31 patients, of which velopharyngeal insufficiency (VPI) in the first follow-up converted to velopharyngeal competence (VPC) in the second follow-up, accounting for 18.79% of the total, and 134 patients had consistent velopharyngeal function. The patients in the group who had consistent velopharyngeal function were younger than those in the group who were inconsistent, and the differences between the two groups were statistically significant. The younger the operation age, the patient's velopharyngeal function was more likely to stabilize at the first follow-up. At the time of the first follow-up in 15, 28, and 40 months, the probability that the patients had stable postoperative velopharyngeal function was 80%, 90%, and 95%, respectively.
The recovery of velopharyn-geal function after surgery is a dynamic process. The velopharyngeal status of patients can be converted from VPI to VPC. Meanwhile, VPC cannot switch to VPI. The follow-up time is the most important factor affecting the consistency of the evaluation of velopharyngeal function. Choosing appro-priate follow-up time is the key to obtain the stable evaluation of velopharyngeal function.
探讨腭裂一期修复术后腭咽功能恢复规律及其与不同手术方式、年龄、腭裂类型和随访时间的相关性。
纳入5岁以下且有2次以上随访记录的腭裂患者，对术后腭咽功能进行连续评估。采用单因素和多因素logistic回归分析揭示术后腭咽功能规律及可能的影响因素。
共纳入165例患者。31例患者腭咽闭合功能不一致，其中首次随访时腭咽功能不全（VPI）在第二次随访时转变为腭咽功能正常（VPC），占总数的18.79%，134例患者腭咽功能一致。腭咽功能一致组患者年龄小于功能不一致组，两组差异有统计学意义。手术年龄越小，患者腭咽功能越有可能在首次随访时稳定。在15、28和40个月首次随访时，患者术后腭咽功能稳定的概率分别为80%、90%和95%。
术后腭咽功能恢复是一个动态过程。患者的腭咽状态可从VPI转变为VPC。同时，VPC不会转变为VPI。随访时间是影响腭咽功能评估一致性的最重要因素。选择合适的随访时间是获得稳定腭咽功能评估的关键。
