Birch Alison L, Jordan Zoe V, Ferguson Louisa M, Kelly Clare B, Boorman John G
South Thames Cleft Service, Evelina London, 8945Guys and St Thomas' NHS Foundation Trust, Northern Ireland, United Kingdom.
Department of Women and Children's Health, 4616Kings College London, Northern Ireland, United Kingdom.
Cleft Palate Craniofac J. 2022 Mar;59(3):277-290. doi: 10.1177/10556656211010623. Epub 2021 Jun 4.
To report speech outcomes following Orticochea pharyngoplasty in 43 patients with cleft palate and noncleft velopharyngeal dysfunction.
A retrospective surgical audit of patients undergoing Orticochea pharyngoplasty between 2004 and 2012, with speech as a primary outcome measure.
Patients known to a regional UK cleft center.
Forty-three patients underwent Orticochea pharyngoplasty by a single surgeon in a UK regional cleft center. Twenty-one patients had undergone a prior procedure for velopharyngeal dysfunction. Pre- and postoperative speech samples were assessed blindly using the Cleft Audit Protocol for Speech-Augmented by a specialist cleft speech and language therapist, external to the team. Speech samples were rated on the following parameters: hypernasality, hyponasality, audible nasal emission, nasal, turbulence, and passive cleft speech characteristics. Statistical differences in pre- and postoperative speech scores were tested using the Wilcoxon matched-pairs signed-ranks test. Inter- and intrareliability scores were calculated using weighted Cohen κ.
Whole group: A statistically significant difference in pre- and postoperative scores for hypernasality ( < .001), hyponasality ( < .05), nasal emission ( < .01), and passive cleft speech characteristics ( < .01) were reported. Patients with cleft diagnoses: A statistically significant difference in scores for hypernasality ( < .001), nasal emission ( < .01), and passive cleft speech characteristics ( < .01) were reported for this group of patients. Patients with noncleft diagnoses: The only parameter to demonstrate a statistically significant difference was hypernasality ( < .01) in this group.
Orticochea pharyngoplasty is a successful surgical procedure in treating velopharyngeal dysfunction in both the cleft and noncleft populations.
报告43例腭裂和非腭裂性腭咽功能不全患者接受奥尔蒂乔切亚咽成形术后的语音结果。
对2004年至2012年间接受奥尔蒂乔切亚咽成形术的患者进行回顾性手术审计，以语音作为主要结果指标。
英国一个地区性腭裂中心的已知患者。
43例患者在英国一个地区性腭裂中心由一名外科医生进行了奥尔蒂乔切亚咽成形术。21例患者此前曾接受过腭咽功能不全的治疗。术前和术后的语音样本由团队外的一名专业腭裂语音和语言治疗师使用《腭裂语音增强审计方案》进行盲法评估。语音样本根据以下参数进行评分：高鼻音、低鼻音、可闻鼻音、鼻音、湍流和被动腭裂语音特征。术前和术后语音评分的统计学差异采用威尔科克森配对符号秩检验进行测试。使用加权科恩κ计算组间和组内信度分数。
全组：报告高鼻音（P<0.001）、低鼻音（P<0.05）、鼻音（P<0.01）和被动腭裂语音特征（P<0.01）术前和术后评分有统计学显著差异。腭裂诊断患者：该组患者高鼻音（P<0.001）、鼻音（P<0.01）和被动腭裂语音特征（P<0.01）评分有统计学显著差异。非腭裂诊断患者：该组中唯一显示有统计学显著差异的参数是高鼻音（P<0.01）。
奥尔蒂乔切亚咽成形术是治疗腭裂和非腭裂人群腭咽功能不全的一种成功的外科手术。
