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[班吉儿科大学医院(中非共和国)的腭裂漏治情况]

[Neglected cleft palate treatment at the Pediatric university hospital of Bangui (Central African Republic)].

作者信息

Ouaïmon Daniel Sylvère, Ndoma Ngatchoukpo Valère, Sopio Jacob Israël Junior, Borohoul Arnaud Rodrigue

机构信息

Centre hospitalier universitaire pédiatrique de Bangui (CHUPB), République centrafricaine.

Faculté des sciences de la santé de l'université de Bangui, République centrafricaine.

出版信息

Med Trop Sante Int. 2023 May 30;3(2). doi: 10.48327/mtsi.v3i2.2023.377. eCollection 2023 Jun 30.

DOI:10.48327/mtsi.v3i2.2023.377
PMID:37525684
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10387319/
Abstract

Cleft palate is the absence of the vault of the mouth resulting in communication between the nose and the mouth. The current frequency of cleft is 0.3% among black people. The incriminated etiological factors of this congenital malformation are exogenous and genetic. The diagnostic is clinical and above all marked by the consequences linked to the cleft, which are multiple morphological problems entailing difficulties from the first days of life (sackling impossible in the event of total cleft lip and palate), functional disorders linked to cleft velopalatine by bucco-nasal reflux, major phonation disorder, dysfunction of the Eustachian tubes causing hearing and otorhinolaryngology (ORL) disorders, breathing disorders. Thanks to the progress of ultrasound, the diagnosis can sometimes be made during pregnancy. Obstetric ultrasound can diagnose cleft lip and palate from the 16th week of amenorrhea. The Veau-Wardill classification based on embryology makes it possible to understand the different types.The care is now organized in a multidisciplinary frameware where the coordination of each specialty will make it possible to harmonize the different treatments. The current attitude is based on the principe of early management to restore the functionality of the velopalatine muscle straps as quickly as possible, reducing the risk of phonatory and auditory sequelae.Concerning cleft palates, the data are fragmented and almost non-existent in the Central African Republic, hence the interest in publishing this clinical case highlighted by chance. We report a clinical case of neglected cleft palate in a 13-year-old girl discovered during a cleft lip and palate screening campaign at the Pediatric University Hospital of Bangui.

摘要

腭裂是口腔穹窿缺失,导致鼻腔与口腔相通。目前黑人中腭裂的发生率为0.3%。这种先天性畸形的病因包括外源性和遗传性因素。诊断主要依靠临床,尤其是由腭裂相关后果所显著体现,这些后果包括多种形态学问题,从出生第一天起就会带来困难(如完全性唇腭裂时无法吸吮)、因腭咽裂导致的功能性紊乱(如口鼻反流)、严重的发声障碍、咽鼓管功能障碍引起的听力及耳鼻喉科(ORL)疾病、呼吸紊乱。得益于超声技术的进步,有时在孕期就能做出诊断。产科超声在闭经第16周时可诊断唇腭裂。基于胚胎学的沃迪尔分类法有助于理解不同类型。目前的治疗在多学科框架下进行组织,各专业之间的协调将使不同治疗得以统一。当前的治疗态度基于早期管理原则,即尽快恢复腭帆提肌的功能,降低发声和听觉后遗症的风险。关于腭裂,在中非共和国数据零散且几乎不存在,因此有兴趣发表这例偶然发现的临床病例。我们报告一例13岁女孩被忽视的腭裂临床病例,该病例是在班吉儿科大学医院的唇腭裂筛查活动中发现的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/1e132939a162/mtsi-03-5404-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/0589f1c1f530/mtsi-03-5404-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/2bcee772ca47/mtsi-03-5404-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/975a487b2889/mtsi-03-5404-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/1e132939a162/mtsi-03-5404-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/0589f1c1f530/mtsi-03-5404-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/2bcee772ca47/mtsi-03-5404-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/975a487b2889/mtsi-03-5404-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2688/10387319/1e132939a162/mtsi-03-5404-g004.jpg

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Med Trop Sante Int. 2023 May 30;3(2). doi: 10.48327/mtsi.v3i2.2023.377. eCollection 2023 Jun 30.
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本文引用的文献

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Evidence-Based Medicine: Cleft Palate.循证医学:腭裂
Plast Reconstr Surg. 2017 Jan;139(1):191e-203e. doi: 10.1097/PRS.0000000000002854.
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Timing of cleft lip and palate repair.唇腭裂修复的时机。
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Analysis of complications in primary cleft lips and palates surgery.原发性唇腭裂手术并发症分析
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Cleft oronasal fistula: a review of treatment results and a surgical management algorithm proposal.口鼻瘘:治疗结果回顾及手术管理算法建议
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Familial risk of oral clefts by morphological type and severity: population based cohort study of first degree relatives.按形态类型和严重程度划分的口腔裂隙家族风险:基于人群的一级亲属队列研究
BMJ. 2008 Feb 23;336(7641):432-4. doi: 10.1136/bmj.39458.563611.AE. Epub 2008 Feb 4.
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Use of vomer flap in palatoplasty: revisited.犁骨瓣在腭裂修复术中的应用:再探讨。
Cleft Palate Craniofac J. 2006 Jan;43(1):30-7. doi: 10.1597/04-034.1.
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[Syphilis and pregnancy].[梅毒与妊娠]
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