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术前软腭闭合率与非综合征性黏膜下腭裂患者 Furlow 腭裂修补术的疗效相关。

Preoperative velopharyngeal closure ratio correlates with Furlow palatoplasty outcome among patients with nonsyndromic submucous cleft palate.

机构信息

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China.

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Ren Min Nan Road, Chengdu, 610041, PR China.

出版信息

J Craniomaxillofac Surg. 2020 Oct;48(10):962-968. doi: 10.1016/j.jcms.2020.08.005. Epub 2020 Sep 3.

Abstract

This study aimed to explore the preoperative factors that are potentially associated with the outcome of Furlow palatoplasty in treating nonsyndromic submucous cleft palate (SMCP). In this study, we reviewed patients with nonsyndromic SMCP who received Furlow palatoplasty between 2008 and 2017 at our department. A comprehensive panel of preoperative variables was included for analyses including gender, age at operation, concurrence of cleft lip, preoperative hypernasality, nasal emission, velopharyngeal closure ratio (VCR), velopharyngeal closure pattern, velum and pharyngeal wall movement, presence of Passavant Ridge and articulation error. The improvement of velopharyngeal function was considered a good outcome. Both univariate and multivariate analyses were performed to screen the potential predictors of the postoperative velopharyngeal function. Multivariate regression analyses indicated preoperative VCR as the only factor that was significantly associated with surgical outcome (p = 0.025). The receiver operating characteristic curve and Youden index indicated that VCR>52.5% was the cutoff value for predicting preferable postoperative velopharyngeal function (OR, 0.240; 95% IC, 0.059-0.979; p = 0.047). In conclusion, Furlow palatoplasty was recommended for non-syndromic SMCP patient with preoperative VCR>52.5% as the primary surgical treatment.

摘要

本研究旨在探讨与 Furlow 腭裂修补术治疗非综合征性黏膜下腭裂(SMCP)结局相关的术前因素。在本研究中,我们回顾了 2008 年至 2017 年在我科接受 Furlow 腭裂修补术的非综合征性 SMCP 患者。对包括性别、手术年龄、唇裂合并、术前鼻音亢进、鼻漏气、腭咽闭合率(VCR)、腭咽闭合模式、软腭和咽壁运动、是否存在帕萨万特嵴以及发音错误在内的一整套术前变量进行了综合分析。将腭咽功能的改善定义为良好的手术效果。分别进行了单因素和多因素分析,以筛选术后腭咽功能的潜在预测因素。多元回归分析表明,术前 VCR 是唯一与手术结果显著相关的因素(p=0.025)。受试者工作特征曲线和约登指数表明,VCR>52.5%是预测术后腭咽功能较好的截断值(OR,0.240;95%CI,0.059-0.979;p=0.047)。总之,对于术前 VCR>52.5%的非综合征性 SMCP 患者,建议采用 Furlow 腭裂修补术作为主要的手术治疗方法。

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