国际口腔医学杂志 ›› 2018, Vol. 45 ›› Issue (3): 368-372.doi: 10.7518/gjkq.2018.03.023

• 综述 • 上一篇    

黏膜下腭裂的诊断及治疗

史佳虹, 鲁勇   

  1. 南京大学医学院附属口腔医院口腔颌面外科 南京 210008
  • 收稿日期:2017-09-10 修回日期:2018-02-05 发布日期:2018-05-08
  • 通讯作者: 鲁勇,副主任医师,博士,Email:cleft_surgery@sina.com
  • 作者简介:史佳虹,硕士,Email:camillashjh@163.com
  • 基金资助:
    江苏省卫生厅医学科研项目(H201239);南京市医学科技发展项目(YKK15117,QRX11125)

Research progress on diagnosis and treatment for submucous cleft palate

Shi Jiahong, Lu Yong   

  1. Dept. of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2017-09-10 Revised:2018-02-05 Published:2018-05-08
  • Supported by:
    This study was supported by the Project of Medical Scientific Research of Health Department of Jiangsu Province (H201239) and the Project of Science and Technology Development of Nanjing (YKK15117, QRX11125).

摘要: 黏膜下腭裂作为腭裂的一种特殊类型,主要临床表现为两侧悬雍垂分叉、硬腭后缘V形骨质缺损、软腭肌肉中线不连续呈透亮影的三联征及腭咽闭合不全、中耳炎等,现存在诊断延误、疗效不佳等问题,需要引起临床注意。本文就其病理病因,临床表现、诊断、分类及治疗方面作一简要综述。

关键词: 黏膜下腭裂, 腭咽闭合不全, 三联征诊断

Abstract: Submucous cleft palate (SMCP) is a special type of cleft palate, presenting the classic clinical features which are a bifid uvula, a midline transluscent zone (zonapellucida) of the soft palate, and a palpable bony notch within the posterior hard palate. Abnormal insertion of the levator palatini muscle causes velopharyngeal insufficiency (VPI), otitis media and so on. There are always late discovery of SMCP and we observed that the VPI incidence after palatoplasty for SMCP patients was higher than that of other cases of cleft palate. So much attention should be paid to SMCP. This article makes a brief summary of the pathological causes, clinical manifestations, diagnosis and treatment.

Key words: submucous cleft palate, velopharyngeal insufficiency, triad syndrome diagnosis

中图分类号: 

  • R782.2+2
[1] Weatherley-White RC, Sakura CY Jr, Brenner LD, et al.Submucous cleft palate. Its incidence, natural history, and indications for treatment[J]. Plast Re-constr Surg, 1972, 49(3):297-304.
[2] García Velasco M, Ysunza A, Hernandez X, et al.Diagnosis and treatment of submucous cleft palate: a review of 108 cases[J]. Cleft Palate J, 1988, 25(2): 171-173.
[3] Hanny KH, de Vries IA, Haverkamp SJ, et al. Late detection of cleft palate[J]. Eur J Pediatr, 2016, 175(1):71-80.
[4] Reiter R, Brosch S, Wefel H, et al.The submucous cleft palate: diagnosis and therapy[J]. Int J Pediatr Otorhinolaryngol, 2011, 75(1):85-88.
[5] Park TS, Bae YC, Nam SB, et al.Postoperative speech outcomes and complications in submucous cleft palate patients[J]. Arch Plast Surg, 2016, 43(3): 254-257.
[6] 胡晓, 李叶扬, 梁岷, 等. 维甲酸改变腭突发育关键时期细胞增殖和凋亡导致腭裂[J]. 中华整形外科杂志, 2016, 32(3):220-224.
Hu X, Li YY, Liang M, et al.Induced cleft palat by retinoic acid through altering the cell proliferation and apoptosis at the key stages of palatal development[J]. Chin J Plast Surg, 2016, 32(3):220-224.
[7] Cohen SR, Chen L, Trotman CA, et al.Soft-palate myogenesis: a developmental field paradigm[J]. Cleft Palate Craniofac J, 1993, 30(5):441-446.
[8] Stal S, Hicks MJ.Classic and occult submucous cleft palates: a histopathologic analysis[J]. Cleft Palate Craniofac J, 1998, 35(4):351-358.
[9] Reiter R, Brosch S, Lüdeke M, et al.Genetic and environmental risk factors for submucous cleft palate[J]. Eur J Oral Sci, 2012, 120(2):97-103.
[10] Funato N, Nakamura M, Richardson JA, et al.Tbx1 regulates oral epithelial adhesion and palatal deve-lopment[J]. Hum Mol Genet, 2012, 21(11):2524-2537.
[11] Calnan J.Submucous cleft palate[J]. Br J Plast Surg, 1954, 6(4):264-282.
[12] Archer K, Marrinan E, Stearns S, et al.Uvular mal-formation in the presence of deformational plagio-cephaly[J]. J Craniofac Surg, 2015, 26(3):836-839.
[13] Shprintzen RJ, Schwartz RH, Daniller A, et al.Mor-phologic significance of bifid uvula[J]. Pediatrics, 1985, 75(3):553-561.
[14] Ominato R, Kobayashi T, Kodama Y, et al.Clinical investigation of patients with submucous cleft palate: diagnosis and clinical manifestations[J]. J Japan Cleft Palate Assoc, 2016, 41(1):24-30.
[15] Oji T, Sakamoto Y, Ogata H, et al.A 25-year review of cases with submucous cleft palate[J]. Int J Pediatr Otorhinolaryngol, 2013, 77(7):1183-1185.
[16] ten Dam E, van der Heijden P, Korsten-Meijer AG, et al. Age of diagnosis and evaluation of consequences of submucous cleft palate[J]. Int J Pediatr Otorhino-laryngol, 2013, 77(6):1019-1024.
[17] Ha KM, Cleland H, Greensmith A, et al.Submucous cleft palate: an often-missed diagnosis[J]. J Craniofac Surg, 2013, 24(3):878-885.
[18] Friedman MA, Miletta N, Roe C, et al.Cleft palate, retrognathia and congenital heart disease in velo-cardio-facial syndrome: a phenotype correlation study[J]. Int J Pediatr Otorhinolaryngol, 2011, 75(9):1167-1172.
[19] Stern Y, Segal K, Yaniv E.Endoscopic adenoidec-tomy in children with submucosal cleft palate[J]. Int J Pediatr Otorhinolaryngol, 2006, 70(11):1871-1874.
[20] Mostafa E, Rezk I, Awad AH.Assessing palatal mobility in post-tonsillectomy patients[J]. Egypt J Ear Nose Throat All Sci, 2016, 17(2):71-73.
[21] Fulcher A, Purcell AA, Baker E, et al.Listen up: children with early identified hearing loss achieve age-appropriate speech/language outcomes by 3 years-of-age[J]. Int J Pediatr Otorhinolaryngol, 2012, 76(12):1785-1794.
[22] Perry JL, Kuehn DP, Wachtel JM, et al.Using magnetic resonance imaging for early assessment of submucous cleft palate: a case report[J]. Cleft Palate Craniofac J, 2012, 49(4):e35-e41.
[23] Mori Y, Hoshi K, Takato T, et al.Submucous cleft palate: variations in bony defects of the hard palate[J]. Br J Oral Maxillofac Surg, 2013, 51(8):e220-e223.
[24] Ren S, Ma L, Zhou X, et al.Bony defect of palate and vomer in submucous cleft palate patients[J]. Int J Oral Maxillofac Surg, 2015, 44(1):63-66.
[25] Sommerlad BC, Fenn C, Harland K, et al.Submucous cleft palate: a grading system and review of 40 con-secutive submucous cleft palate repairs[J]. Cleft Palate Craniofac J, 2004, 41(2):114-123.
[26] Smyth AG.Submucous cleft palate: outcomes after primary repair with repositioning of the levator muscle in 51 consecutive patients[J]. Br J Oral Maxillofac Surg, 2016, 54(5):561-567.
[27] Smyth A.Clinical grading system for submucous cleft palate[J]. Br J Oral Maxillofac Surg, 2014, 52(3):275-276.
[28] 尹恒, 郭春丽, 石冰, 等. 黏膜下腭裂的形态分类与腭咽功能分析[J]. 华西口腔医学杂志, 2016, 34(5): 488-492.
Yin H, Guo CL, Shi B, et al.Morphological classifi-cation and velopharyngeal function analysis of sub-mucous cleft palate patients[J]. West Chin J Stomatol, 2016, 34(5):488-492.
[29] McWilliams BJ. Submucous clefts of the palate: how likely are they to be symptomatic[J]. Cleft Palate Cra-niofac J, 1991, 28(3):247-251.
[30] Shah S, Garg R, Uppal SK, et al.Sub mucous cleft palate with fenestration[J]. Int J Appl Basic Med Res, 2014, 4(Suppl 1):S56-S57.
[31] 屈文静, 尹宁北. 隐性腭裂手术治疗进展[J]. 中国美容医学, 2012, 21(9):1659-1662.
Qu WJ, Yin NB.Surgical treatment progress of submucous cleft palate[J]. Chin J Aesth Med, 2012, 21(9):1659-1662.
[1] 黄汉尧, 王梦娇, 吴昊, 蒋莉萍, 张文婧, 韦杉, 尹恒. 腭咽闭合不全相关生存质量量表信度与效度的验证[J]. 国际口腔医学杂志, 2018, 45(2): 177-184.
[2] 李盛,江宏兵,万林忠,袁华,汪彬昺,姜成惠,杜一飞飞. 腭咽闭合不全的个体化治疗策略[J]. 国际口腔医学杂志, 2016, 43(6): 640-644.
[3] 宗弋 王敤 王虎. 腭裂修复术后软腭形态多样性的研究[J]. 国际口腔医学杂志, 2015, 42(3): 281-284.
[4] 陈晓容1 赵彪1 尹恒2. 腭裂术后边缘性腭咽闭合不全的语音训练特点[J]. 国际口腔医学杂志, 2011, 38(3): 279-282.
[5] 蒙田,鲁勇,郑谦,石冰,. 腭帆提肌重建术的研究应用进展[J]. 国际口腔医学杂志, 2006, 33(05): 377-378.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 张京剧. 青年期至中年期颅面复合体变化的头影测量研究[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 王昆润. 在种植体上制作固定义齿以后下颌骨密度的动态变化[J]. 国际口腔医学杂志, 1999, 26(06): .
[3] 王昆润. 修补颌骨缺损的新型生物学相容材料[J]. 国际口腔医学杂志, 1999, 26(06): .
[4] 汤庆奋,王学侠. 17β-雌二醇对人类阴道和口腔颊粘膜的渗透性[J]. 国际口腔医学杂志, 1999, 26(06): .
[5] 宋红. 青少年牙周炎外周血分叶核粒细胞的趋化功能[J]. 国际口腔医学杂志, 1999, 26(06): .
[6] 张新春. 桩冠修复与无髓牙的保护[J]. 国际口腔医学杂志, 1999, 26(06): .
[7] 康非吾. 种植义齿下部结构生物力学研究进展[J]. 国际口腔医学杂志, 1999, 26(05): .
[8] 蔡霞,李成章. 前列腺素E_2受体EP亚型在牙周炎发病机制中的作用[J]. 国际口腔医学杂志, 2005, 32(06): 461 -462 .
[9] 黄维佳综述 平飞云审校. 涎腺黏膜相关淋巴组织淋巴瘤的研究进展[J]. 国际口腔医学杂志, 2009, 36(5): 577 -579 .
[10] 聂盼 李婧 李伟. Activator 治疗骨性Ⅱ类畸形的临床应用[J]. 国际口腔医学杂志, 2011, 38(4): 380 -383 .