Gereau S A, Shprintzen R J
Center for Craniofacial Disorders, Montefiore Medical Center, Bronx, NY 10467.
Laryngoscope. 1988 Mar;98(3):299-303. doi: 10.1288/00005537-198803000-00012.
The controversy surrounding the various approaches to palate repair continues unabated. Issues which have been studied relative to the development of normal speech following palate repair have included surgical technique and the timing of surgery. However, regardless of the various refinements in surgery, a percentage of children require secondary surgery to resolve velopharyngeal insufficiency. To date, other factors which might be responsible for the development of normal speech have been ignored. The purpose of this report is to discuss the importance of the relative size of the adenoids in relation to the success or failure of primary palatoplasty. Velopharyngeal valving in noncleft (normal) children was also observed. Eight hundred fifty children with nonsyndromic clefts and 138 children with syndromic clefts were analyzed for speech results postpalatoplasty relative to adenoid size. One hundred normal children were also studied. The data suggest a strongly positive correlation between the incidence of hypernasal resonance postpalatoplasty and relative adenoid size in the cleft children. Velar-adenoidal closure was consistently observed in both the cleft and normal children.
围绕腭裂修复的各种方法的争议仍在持续。与腭裂修复后正常语音发展相关的已研究问题包括手术技术和手术时机。然而，无论手术有多少改进，仍有一定比例的儿童需要二次手术来解决腭咽闭合不全问题。迄今为止，其他可能导致正常语音发展的因素一直被忽视。本报告的目的是讨论腺样体相对大小与一期腭裂修复术成败的重要性。还观察了非腭裂（正常）儿童的腭咽瓣关闭情况。分析了850例非综合征性腭裂儿童和138例综合征性腭裂儿童腭裂修复术后的语音结果与腺样体大小的关系。还研究了100名正常儿童。数据表明，腭裂儿童腭裂修复术后高鼻音发生率与腺样体相对大小之间存在强正相关。在腭裂儿童和正常儿童中均持续观察到腭帆-腺样体闭合。
