Kashiwagi Miki, Saijo Hideto, Oshima Sachi, Ichikawa Shota, Narita Rika, Hoshi Kazuto
Department of Oral and Maxillo-Facial Surgery and Orthodontics, The University of Tokyo Hospital, Tokyo, Japan.
Department of Oral and Maxilloacial Surgery, The University of Osaka, Osaka, Japan.
PLoS One. 2025 May 28;20(5):e0323503. doi: 10.1371/journal.pone.0323503. eCollection 2025.
Cleft lip and palate (CLP) is one of the most common congenital anomalies, affecting ~1 in 700 births worldwide. Patients with CLP often experience functional impairments due to the cleft palate, particularly related to feeding and speech. Surgical interventions are essential for addressing these issues, yet no standardized surgical procedure exists. Velar adhesion (VA) is a technique used to reduce the cleft width prior to a palatoplasty, potentially improving surgical outcomes, but its effectiveness remains unclear.
The impact of VA on cleft-width reduction and the incidence of otitis media with effusion (OME) were evaluated in patients with unilateral cleft lip and palate (UCLP).
The cases of 45 patients with UCLP who underwent a palatoplasty at the University of Tokyo Hospital between January 2013 and December 2023 were analyzed retrospectively. We divided the patients into two groups: those who underwent VA during lip repair (VA group) and those who did not (non-VA group). The cleft width and alveolar cleft width were measured at birth, lip repair, and palatoplasty. The presence of OME was assessed the day before the palatoplasty. Pearson's chi-square test and the two-tailed t-test were applied.
Significant cleft-width reduction was observed in the VA group compared to the non-VA group at the time of palatoplasty (4.58 mm vs. 6.55 mm, p < 0.01). The incidence of OME was significantly lower in the VA group (60.00%) versus the non-VA group (90.91%, p < 0.01). No significant between-group differences were identified for the alveolar cleft width or maxillary growth.
VA significantly reduces the cleft width at the junction of the hard and soft palates, and it may decrease the incidence of otitis media with effusion in patients with UCLP. VA is a straightforward procedure with potential benefits for improving palatoplasty outcomes and mitigating complications such as OME.
唇腭裂（CLP）是最常见的先天性畸形之一，全球每700例出生中约有1例受影响。唇腭裂患者常因腭裂而出现功能障碍，尤其是与喂养和言语相关的功能障碍。手术干预对于解决这些问题至关重要，但目前尚无标准化的手术程序。腭帆粘连（VA）是一种在腭裂修复术前用于缩小腭裂宽度的技术，可能会改善手术效果，但其有效性仍不明确。
评估腭帆粘连（VA）对单侧唇腭裂（UCLP）患者腭裂宽度缩小及中耳积液（OME）发生率的影响。
回顾性分析2013年1月至2023年12月在东京大学医院接受腭裂修复术的45例单侧唇腭裂患者的病例。我们将患者分为两组：在唇修复术中接受腭帆粘连的患者（VA组）和未接受腭帆粘连的患者（非VA组）。在出生时、唇修复时和腭裂修复时测量腭裂宽度和牙槽裂宽度。在腭裂修复术前一天评估中耳积液的情况。应用Pearson卡方检验和双尾t检验。
与非VA组相比，VA组在腭裂修复时腭裂宽度显著缩小（4.58毫米对6.55毫米，p < 0.01）。VA组中耳积液的发生率显著低于非VA组（60.00%对90.91%，p < 0.01）。两组在牙槽裂宽度或上颌骨生长方面未发现显著差异。
腭帆粘连显著缩小硬腭与软腭交界处的腭裂宽度，并且可能降低单侧唇腭裂患者中耳积液的发生率。腭帆粘连是一种简单的手术，对改善腭裂修复效果和减轻中耳积液等并发症具有潜在益处。
