Marsh J L, Wray R C
Plast Reconstr Surg. 1980 May;65(5):592-4. doi: 10.1097/00006534-198005000-00009.
Thirty-nine children with moderate-to-severe velopharyngeal incompetency were randomly assigned to either prosthetic or surgical palatal management. A classification for evaluating velopharyngeal incompetency was designed. The prosthetic speech appliance, when obtained and tolerated, corrected velopharyngeal incompetency as effectively as did pharyngeal flap surgery. However, the noncompliance and failure rate for prosthetic management was 35 percent. The surgical failure rate was 9 percent. Furthermore, 33 percent of patients who received prosthetic management have subsequently undergone pharyngeal flap surgery. The equivalency of these types of palatal management lead one to question the combination of the noncompliance and failure rate for prostheses, the incidence of secondary surgical conversions, and the persistent sense of deformity with prosthetic management.
39名中重度腭咽闭合不全的儿童被随机分为接受修复治疗或手术治疗两组。设计了一种评估腭咽闭合不全的分类方法。当获得并耐受时，修复性语音矫治器纠正腭咽闭合不全的效果与咽瓣手术相同。然而，修复治疗的不依从率和失败率为35%。手术失败率为9%。此外，接受修复治疗的患者中有33%随后接受了咽瓣手术。这些腭部治疗类型的等效性让人质疑修复体的不依从率和失败率、二次手术转换的发生率以及修复治疗中持续存在的畸形感的综合情况。
