Younger R, Dickson R I
J Otolaryngol. 1985 Jun;14(3):158-62.
Nine adults underwent superiorly based pharyngeal flaps for the treatment of severe velopharyngeal insufficiency (VPI). The etiology of the VPI was failed pediatric cleft palate repair in eight and myasthenia gravis in the ninth. All patients were evaluated by a speech therapist pre-operatively. There were no significant early or late postsurgical complications. After extensive speech therapy all patients were noted subjectively and objectively to have a marked reduction in hypernasality and nasal air escape and improved speech intelligibility. The healed fibrotic flaps appeared to be adynamic and acted more as a viable midline obturator. Lateral pharyngeal wall contraction was necessary to close the lateral ports during phonation. The patient with myasthenia gravis had the least improvement presumably due to poor lateral wall mobility.
9名成年人接受了基于上方的咽瓣手术，以治疗严重的腭咽闭合不全（VPI）。VPI的病因在8例中是小儿腭裂修复失败，第9例是重症肌无力。所有患者术前均由言语治疗师进行评估。术后早期和晚期均无明显并发症。经过广泛的言语治疗后，所有患者在主观和客观上均表现出鼻音过重和鼻腔漏气明显减少，言语清晰度提高。愈合的纤维化咽瓣似乎无活力，更多地起到了可行的中线封闭器的作用。发声时需要咽侧壁收缩以关闭侧方通道。重症肌无力患者改善最少，可能是由于咽侧壁活动度差。
