Department of Oral and Maxillofacial Surgery, The First Hospital of Lanzhou University and School of Stomatology of Lanzhou University, Lanzhou, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen.
Department of Oral and Maxillofacial Surgery, Gansu Provincial Hospital, Lanzhou.
Int J Oral Maxillofac Surg. 2021 Feb;50(2):191-197. doi: 10.1016/j.ijom.2020.07.016. Epub 2020 Aug 2.
The aim of this study was to clinically evaluate the effectiveness of various palatoplasty techniques for the repair of cleft palates greater than 8mm in width. This prospective cohort study included 142 patients with complete cleft palate between September 2017 and January 2019. Among the patients, 60 underwent a modified palatoplasty with Furlow Z-plasty (MPFZP), 51 underwent a von Langenbeck (VL) repair, and 31 underwent a two-flap palatoplasty (2FP). The MPFZP technique was modified with bilateral relaxing incisions and a radical intravelar veloplasty. Descriptive statistics and the χ test were used to explore and compare the rates of complications among the three surgical techniques. No statistically significant difference in sex, age at repair, cleft width, or cleft Veau type was found among the three groups. Rates of wound dehiscence at 1 week and fistula formation at 3 months after the surgery also did not differ significantly among the three techniques. However, velopharyngeal function for speech was better in patients who underwent MPFZP compared to the other two techniques (P<0.05). The repair of a wide cleft palate can be difficult due to the tension at closure. Although the study findings did not demonstrate a difference in complication rates among the three techniques, MPFZP appears to have the best functional outcomes in patients with a cleft palate wider than 8mm.
本研究旨在临床评估多种腭裂修复技术治疗宽度大于 8mm 的腭裂的效果。这项前瞻性队列研究纳入了 2017 年 9 月至 2019 年 1 月期间的 142 例完全性腭裂患者。其中 60 例行改良 Furlow Z 成形术（MPFZP），51 例行 von Langenbeck（VL）修复术，31 例行双瓣腭裂修复术（2FP）。MPFZP 技术采用双侧松弛切口和彻底的内收肌成形术进行改良。采用描述性统计和 χ 检验探讨并比较三种手术技术的并发症发生率。三组患者的性别、修复时年龄、裂隙宽度或裂隙 Veau 类型无统计学差异。术后 1 周伤口裂开率和术后 3 个月瘘管形成率在三种技术之间也无显著差异。然而，与其他两种技术相比，MPFZP 组患者的语音腭咽功能更好（P<0.05）。由于缝合时的张力，宽裂隙腭裂的修复较为困难。尽管研究结果并未显示三种技术的并发症发生率存在差异，但对于宽度大于 8mm 的腭裂患者，MPFZP 似乎具有最佳的功能效果。
