From the Division of Pediatric Plastic Surgery, Advocate Children's Hospital.
Department of Plastic Surgery, Division of Pediatric Plastic Surgery, University of Pittsburgh.
Plast Reconstr Surg. 2024 Aug 1;154(2):378e-390e. doi: 10.1097/PRS.0000000000011312. Epub 2024 Jul 22.
After studying this article, the participant should be able to: (1) Describe the pathology of velopharyngeal dysfunction (VPD) as it relates to patients with a cleft palate. (2) Use the perceptual speech assessment and objective diagnostic tools to determine the presence or absence of VPD. (3) Describe the surgical options available for the treatment of patients with VPD. (4) Develop an evidence-based, customized treatment plan for VPD founded on objective considerations.
To treat patients with cleft palate effectively, the surgeon must understand the diagnosis and surgical management of cleft-associated velopharyngeal dysfunction. The authors review diagnostic modalities including perceptual speech assessment, video nasendoscopy, fluoroscopy, magnetic resonance imaging, and nasometry. Surgical treatments including palatal lengthening with buccal myomucosal flaps, conversion Furlow palatoplasty, sphincter pharyngoplasty, and pharyngeal flap are discussed. Selection of an optimal surgical treatment is addressed.
学习本文后，参与者应能够：(1) 描述与腭裂患者相关的腭咽功能障碍 (VPD) 的病理学。(2) 使用感知言语评估和客观诊断工具来确定 VPD 的存在与否。(3) 描述用于治疗 VPD 患者的手术选择。(4) 根据客观考虑制定基于循证的、定制的 VPD 治疗计划。
为了有效地治疗腭裂患者，外科医生必须了解腭裂相关腭咽功能障碍的诊断和手术管理。作者回顾了包括感知言语评估、视频鼻内镜检查、荧光透视、磁共振成像和鼻声反射测量在内的诊断方式。讨论了包括颊黏膜瓣腭延长术、转换式 Furlow 腭裂修补术、括约肌咽成形术和咽瓣术在内的手术治疗。还讨论了选择最佳手术治疗方法的问题。
