Chabolle F, Biacabe B, Sequert C, Cabanes J, Lachiver X, Fleury B
Service ORL et chirurgie face et cou, Hôpital Foch, Suresnes.
Ann Otolaryngol Chir Cervicofac. 1995;112(7):324-9.
Velopharyngeal stenosis is a rare complication of pharyngotomy (UPPP) for chronic snoring. Its treatment is hard because of its recidivant feature. The aim of this study was to determine a therapeutic strategy accorded to each stenosis from clinical and anatomical features of 13 velopharyngeal stenosis. Therapeutic behavior was function of patients complains, of the ground (associated chronic rhinosinusitis and obstructive sleep apnea) and clinical findings (partial or total stenosis, tonsil remainders, short or long residual soft palate). From these data, treatment was medical (1 case) or surgical (12 cases), searching lateral velopharyngeal mucosa recovery in order to avoid recidive of stenosis. This aim needed locoregional mucosal grafts in 4 patients with short soft palate. Patients complains were improved in all cases and there was no patient with recurrence of stenosis. The best treatment of velopharyngeal stenosis still remains a preventive one, by respecting a severe surgical technique during pharyngotomy for chronic snoring.
腭咽狭窄是慢性打鼾行咽切开术（悬雍垂腭咽成形术）罕见的并发症。因其具有复发性，故治疗困难。本研究的目的是根据13例腭咽狭窄患者的临床和解剖特征，确定针对每种狭窄的治疗策略。治疗方式取决于患者的主诉、基础情况（合并慢性鼻-鼻窦炎和阻塞性睡眠呼吸暂停）以及临床发现（部分或完全狭窄、扁桃体残留、软腭残余短或长）。根据这些数据，治疗方式为药物治疗（1例）或手术治疗（12例），旨在恢复腭咽外侧黏膜，以避免狭窄复发。对于4例软腭短的患者，这一目标需要进行局部黏膜移植。所有病例中患者的主诉均得到改善，且无患者出现狭窄复发。对于腭咽狭窄，最佳治疗方法仍是预防性的，即在慢性打鼾行咽切开术时遵循严格的手术技术。
