Jargaldavaa Erdenetsogt, Gongorjav Ayanga, Badral Batbayar, Lkhamsuren Khentii, Ichinkhorloo Narantuya
Department of Maxillofacial Surgery, School of Dentistry, Mongolia.
Department of Pediatric Maxillofacial Surgery, National Center for Maternal and Child Health, Mongolia.
Ann Maxillofac Surg. 2022 Jan-Jun;12(1):27-32. doi: 10.4103/ams.ams_62_22. Epub 2022 Aug 16.
To identify a better method for primary cleft palate (CP) repairs with respect to velopharyngeal function.
A retrospective, longitudinal review of medical charts of patients with congenital CP who underwent four different techniques of palatoplasty, performed by three different surgeons in the Department of Maxillofacial Surgery of the National Center for Maternal and Child Health. Nasopharyngoscopy (NPS) was used for velopharyngeal function evaluation. CP was classified according to the Veau system and the "Golding-Kushner" scale for NPS results was used for assessing the patient's velopharyngeal function and its association with cleft types and the primary palatoplasty techniques. Pearson's Chi-square analysis and binary logistic regression were used for statistical analysis.
A total of 335 patients were included in the study. The mean age at primary palate repair was 22.9 ± 13.6 months. There were 56, 42, 177, and 60 patients with Veau-I, Veau-II, Veau-III, and Veau-IV types, respectively, whereas for primary palatoplasty 65 patients underwent Furlow, 148 patients - Mongolian, 108 patients - two flap, 34 patients - von Langenbeck technique. NPS assessment of adequate velopharyngeal function was followed by Furlow's technique in 89.4% of cases, Mongolian technique in 62.2% of cases but by "two flap" only in 48.1% and von Langenbeck in 47.1% of cases.
The Furlow and Mongolian techniques were superior for maintaining velopharyngeal function after primary palatoplasty.
为了确定在腭咽功能方面更好的原发性腭裂（CP）修复方法。
对国家妇幼保健中心颌面外科由三位不同外科医生采用四种不同腭裂修复技术的先天性CP患者的病历进行回顾性纵向研究。采用鼻咽镜检查（NPS）评估腭咽功能。CP根据Veau系统分类，NPS结果采用“戈尔丁 - 库什纳”量表评估患者的腭咽功能及其与腭裂类型和原发性腭裂修复技术的关联。采用Pearson卡方分析和二元逻辑回归进行统计分析。
本研究共纳入335例患者。初次腭裂修复的平均年龄为22.9±13.6个月。分别有56例、42例、177例和60例患者为Veau - I型、Veau - II型、Veau - III型和Veau - IV型，而在原发性腭裂修复中，65例患者采用Furlow技术，148例患者采用蒙古式技术，108例患者采用双瓣技术，34例患者采用冯·朗根贝克技术。NPS评估腭咽功能良好的情况在Furlow技术组为89.4%的病例，蒙古式技术组为62.2%的病例，但双瓣技术组仅为48.1%的病例，冯·朗根贝克技术组为47.1%的病例。
Furlow技术和蒙古式技术在原发性腭裂修复后维持腭咽功能方面更具优势。
