Chen P K, Wu J T, Chen Y R, Noordhoff M S
Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan.
Plast Reconstr Surg. 1994 Dec;94(7):933-41; discussion 942-3.
To avoid the serious complications of pharyngeal flap surgery, a Furlow palatoplasty was used to correct velopharyngeal insufficiency after primary palatoplasty in 18 Chinese cleft palate patients (3 to 23 years old) from 1988 to 1992. The follow-up duration was 1 to 4 years. These patients were selected after a complete study for velopharyngeal insufficiency, including intraoral examination, perceptual speech assessment, videonasopharyngoscopy, and/or multiview videofluoroscopy. The criteria for selection included age, pattern of velopharyngeal closure, size of the velopharyngeal gap, extent of lateral pharyngeal wall movement, existence of a Passavant's ridge, and abnormal levator veli palatini muscle insertion. Complete velopharyngeal closure was achieved for 16 patients after surgery. The majority of these patients (15) had a velopharyngeal gap less than 5 mm. The 2 patients who still had velopharyngeal insufficiency after the surgery had a velopharyngeal gap larger than 10 mm before the surgery. The most important factor seemed to be the size of the velopharyngeal gap. Pattern of velopharyngeal closure or age of the patient also might play an important role. The results showed that a Furlow palatoplasty can satisfactorily correct velopharyngeal insufficiency in carefully selected patients. Although the criteria for the selection of this operation need further study, present results are encouraging.
为避免咽瓣手术的严重并发症，1988年至1992年期间，对18例年龄在3至23岁的中国腭裂患者在初次腭裂修复术后采用Furlow腭成形术纠正腭咽闭合不全。随访时间为1至4年。这些患者在经过全面研究以评估腭咽闭合不全后被挑选出来，研究包括口腔检查、感知语音评估、鼻咽喉镜检查和/或多视角电视透视检查。选择标准包括年龄、腭咽闭合模式、腭咽间隙大小、咽侧壁运动程度、是否存在Passavant嵴以及腭帆提肌异常附着。术后16例患者实现了完全腭咽闭合。这些患者中的大多数（15例）腭咽间隙小于5毫米。术后仍存在腭咽闭合不全的2例患者术前腭咽间隙大于10毫米。最重要的因素似乎是腭咽间隙的大小。腭咽闭合模式或患者年龄也可能起重要作用。结果表明，Furlow腭成形术可在精心挑选的患者中令人满意地纠正腭咽闭合不全。尽管选择该手术的标准需要进一步研究，但目前的结果令人鼓舞。
