Cosman B, Falk A S
Cleft Palate J. 1980 Jan;17(1):27-33.
In the management of patients with complete palatal clefts early repair of the soft palate (before 1 year of age) and delayed repair of the hard palate (after five or six years of age) has been advocated on the basis that good speech will develop following soft palate closure and that avoidance of trauma to the hard palate will obviate maxillary growth disturbance. In addition, it is said that many of the remaining hard palate fistulas will close spontaneously and that residual hard palate openings will be easy to close. Thirty-two cases treated in this way are reviewed, and a decade of experience with this technique is presented. A majority of cases failed to develop acceptable speech spontaneously. A very high percentage suffered both anterior and posterior air escape and a strikingly high proportion required pharyngeal flaps. Spontaneous complete closure of the hard palate was infrequent. The hard palate openings were not easy to close. The speech deficiencies associated with this technique are clear. The method's possible advantages in relationship to maxillofacial growth remain difficult to prove and were not specifically investigated in this study.
在完全性腭裂患者的治疗中，有人主张早期修复软腭（1岁前）和延迟修复硬腭（5、6岁后），其依据是软腭闭合后会形成良好的语音，且避免硬腭创伤可避免上颌生长发育障碍。此外，据说许多残留的硬腭瘘会自行闭合，且残留的硬腭开口易于闭合。本文回顾了32例采用这种方法治疗的病例，并介绍了该技术十年的经验。大多数病例未能自发形成可接受的语音。很高比例的患者存在前后鼻孔漏气，且需要咽瓣的比例惊人地高。硬腭自发完全闭合的情况很少见。硬腭开口不易闭合。与该技术相关的语音缺陷很明显。该方法在颌面部生长方面可能存在的优势仍难以证明，且本研究未对此进行专门调查。
