State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China.
J Craniomaxillofac Surg. 2023 Apr;51(4):238-245. doi: 10.1016/j.jcms.2023.04.004. Epub 2023 Apr 14.
The purpose of this study was to introduce the surgical process of Sommerlad-Furlow modified (S-F) palatoplasty and compare its surgical and functional outcomes with conventional Sommerlad (S) palatoplasty. Patients with non-syndromic cleft palate who had undergone either S-F palatoplasty or S palatoplasty were retrospectively reviewed. Data on the outcomes of velopharyngeal function and postsurgical palatal fistula incidence were collected for all patients. Data for preselected factors, including gender, age at palatoplasty, and cleft type, were also collected. Chi-square tests were conducted. 1254 patients were included. The postsurgical velopharyngeal competence (VPC) rate after S-F palatoplasty was significantly higher than after S palatoplasty (total, 70.5% vs 57.9%, p < 0.0001; age ≤ 1, 87.0% vs 69.2%, p < 0.0001; 1 < age ≤ 2, 78.3% vs 69.3%, p = 0.0479). With regard to different types of cleft palate, the postsurgical VPC rates after S-F palatoplasty were all significantly higher than for S palatoplasty in all patients younger than 2 years of age (complete cleft palate, 78.7% vs 62.4%, p = 0.0016; hard and soft palate cleft, 84.4% vs 74.8%, p = 0.0172; submucosal cleft and soft palate cleft, 96.6% vs 68.4%, p = 0.0114). The postoperative fistula rate after S-F palatoplasty was 4.3%. This modified palatoplasty technique provided adequate cleft palate closure, with satisfactory speech outcomes and low fistula rates, while older age at palatoplasty may affect the postsurgical outcomes. Within the limitations of the study it seems that the Sommerlad-Furlow modified technique is an option for cleft palate repair.
本研究旨在介绍 Sommerlad-Furlow 改良（S-F）腭裂修补术的手术过程，并比较其与传统 Sommerlad（S）腭裂修补术的手术和功能结果。回顾性分析了接受 S-F 腭裂修补术或 S 腭裂修补术的非综合征性腭裂患者。收集了所有患者的腭咽闭合功能和术后腭裂瘘发生率的结果数据。还收集了包括性别、腭裂修补术时的年龄和腭裂类型等预选因素的数据。进行了卡方检验。共纳入 1254 例患者。S-F 腭裂修补术后的腭咽闭合功能（VPC）率明显高于 S 腭裂修补术（总 VPC 率：70.5%比 57.9%，p<0.0001；年龄≤1 岁：87.0%比 69.2%，p<0.0001；1<年龄≤2 岁：78.3%比 69.3%，p=0.0479）。对于不同类型的腭裂，所有年龄小于 2 岁的患者中，S-F 腭裂修补术后的 VPC 率均明显高于 S 腭裂修补术（完全性腭裂：78.7%比 62.4%，p=0.0016；硬软腭裂：84.4%比 74.8%，p=0.0172；黏膜下腭裂和软腭裂：96.6%比 68.4%，p=0.0114）。S-F 腭裂修补术后的瘘管发生率为 4.3%。这种改良的腭裂修补技术可以提供充分的腭裂关闭，获得满意的语音效果，瘘管发生率低，而腭裂修补术时的年龄较大可能会影响术后结果。在本研究的限制范围内，似乎 Sommerlad-Furlow 改良技术是腭裂修复的一种选择。
