Cantarella G, Mazzola R F, Benincasa A
Clinic ORL I, IRCCS Ospedale Maggiore Policlinico, University of Milan, Italy.
J Neurosurg Sci. 1998 Mar;42(1):51-5.
The authors describe a case of velopharyngeal incompetence (VPI), as a consequence to the neurosurgical treatment for a complex malformation of the cranio-spinal junction. A 61-year-old woman underwent a transoral-transvelar surgical approach for odontoid resection. One month later surgical fixation of the posterior spine with autologous iliac bone graft was performed. Following these operations the patient presented a marked alteration of speech intellegibility due to hypernasal voice resonance and through incapability to articulate the oral phonemes correctly. She also complained of nasal regurgitation of fluids and solids while swallowing. She underwent a clinical phoniatric assessment of voice and speech. Videonasopharyngoscopy allowed us to inspect the velopharyngeal sphincter and to show clearly the type and morphology of its closure defect. Correction of VPI was achieved by means of a velopharyngoplasty (pharyngeal flap), in spite of technical difficulties due to local scarring and to a problematic exposure of the surgical field.
作者描述了一例因颅颈交界区复杂畸形的神经外科治疗导致的腭咽闭合不全（VPI）病例。一名61岁女性接受了经口经腭手术切除齿状突。一个月后，采用自体髂骨移植进行了后路脊柱手术固定。这些手术后，患者出现了明显的语音清晰度改变，表现为鼻音过重以及无法正确发出口腔音素。她还抱怨吞咽时液体和固体有鼻反流现象。她接受了嗓音和语音的临床嗓音评估。鼻咽喉镜检查使我们能够检查腭咽括约肌，并清楚地显示其闭合缺陷的类型和形态。尽管由于局部瘢痕形成和手术视野暴露困难等技术问题，仍通过腭咽成形术（咽瓣）实现了VPI的矫正。
