Okazaki K, Satoh K, Kato M, Iwanami M, Ohokubo F, Kobayashi K
Department of Plastic and Reconstructive Surgery, School of Medicine, Showa University, Tokyo, Japan.
Ann Plast Surg. 1993 Apr;30(4):304-11. doi: 10.1097/00000637-199304000-00003.
The influence of maxillary advancement by osteotomy on speech was examined in 10 patients with cleft palates (6 males, 4 females). Ages at the time of surgery ranged from 16 to 26 years (mean, 19.5 yr). LeFort I and II osteotomies were performed in 9 patients and 1 patient, respectively. Preoperatively and postoperatively, hypernasality, nasal emission on pressure consonants, and articulation disturbances were evaluated perceptually, and velopharyngeal function was evaluated by lateral cephalographic and nasopharyngoscopic studies. Hypernasality, which had been judged preoperatively to be absent or slight in 1 patient each, remained unchanged after surgery, whereas the remaining 8 patients showed increased hypernasality after surgery. Nasal emission showed a similar tendency. Articulation errors were not improved postoperatively. Lateral cephalograms recorded from the patients with increased hypernasality showed increases in the shortest palatopharyngeal length and in the soft-palate-length--to--pharyngeal-depth ratio. Also, deterioration in velopharyngeal closure was noted postoperatively compared with preoperatively by nasopharyngoscopy in the majority of patients with increased hypernasality.
对10例腭裂患者（6例男性，4例女性）进行了截骨术上颌前徙对语音影响的研究。手术时年龄在16至26岁之间（平均19.5岁）。分别有9例和1例患者进行了LeFort I型和II型截骨术。术前和术后，通过主观评估鼻音过重、爆破音时的鼻漏气以及发音障碍，并通过头颅侧位片和鼻咽镜检查评估腭咽功能。术前判断为无或轻度鼻音过重的患者各有1例，术后未改变，而其余8例患者术后鼻音过重加重。鼻漏气也有类似趋势。术后发音错误未改善。鼻音过重加重患者的头颅侧位片显示腭咽最短长度和软腭长度与咽深度之比增加。此外，大多数鼻音过重加重的患者术后鼻咽镜检查显示腭咽闭合与术前相比变差。
