Affiliated Hospital of Stomatology.
Special Key Laboratory of Oral Diseases Research from Higher Education Institution of Guizhou Province, Zunyi Medical University, Zunyi, China.
J Craniofac Surg. 2020 Oct;31(7):e717-e720. doi: 10.1097/SCS.0000000000006673.
At present, there are a variety of surgical methods for cleft palate repair, the authors first created the zigzag plasty of nasal mucosa musculature. The method is characteristic of better repair effect for anatomy and function of palatopharyngeal compared with the traditional method.
Fifty patients with cleft palate were involved in this study, and treated with 3 different operative methods, respectively: zigzag palatoplasty for the repair of nasal mucosa myometrium (n = 17), Sommerlad palatoplasty (n = 18) and the double opposing Z palatoplasty (n = 15), respectively. The length of soft palate (the distance from incisor to the tip of uvula) and the distance from uvula to posterior pharynx before and after operation were selected as outcome index. The post-operative speech intelligibility, nasal resonance, and nasal leaking were also evaluated.
The results showed that the lengths of soft palate were increased by 14.50%, 13.23%, 10.10% with the zigzag palatoplasty, the double opposing Z palatoplasty and Sommerlad palatoplasty, respectively; the distances from the vertical tip to the posterior pharyngeal wall of 3 kinds of operation were reduced by 49.03%, 47.78%, 49.03%, respectively. The comparison of speech intelligibility, nasal resonance and nasal resonance assessment between/among groups were not significant.
The authors' research showed that the effect of zigzag palatoplasty works well in the repair of nasal mucosa myometrium and can be used as an optional method for functional repair of cleft palate.
目前腭裂修复术式多样，作者首次采用黏膜肌瓣“Z”成形术，该方法在解剖和功能修复方面优于传统方法。
对 50 例腭裂患者分别采用黏膜肌瓣“Z”成形术（17 例）、Sommerlad 腭成形术（18 例）和双“Z”成形术（15 例）3 种术式修复，分别观察软腭长度（从切牙到悬雍垂尖端的距离）、悬雍垂后缘至咽后壁距离等手术前后的变化，并对术后语音清晰度、鼻音、腭咽闭合不全等进行评估。
软腭长度分别增加 14.50%、13.23%、10.10%，悬雍垂后缘至咽后壁距离分别减少 49.03%、47.78%、49.03%，3 种术式术后语音清晰度、鼻音、腭咽闭合不全等评估比较差异无统计学意义。
黏膜肌瓣“Z”成形术修复腭裂效果良好，可作为腭裂功能修复的一种选择方法。
