国际口腔医学杂志 ›› 2016, Vol. 43 ›› Issue (6): 640-644.doi: 10.7518/gjkq.2016.06.005

• 论著 • 上一篇    下一篇

腭咽闭合不全的个体化治疗策略

李盛,江宏兵,万林忠,袁华,汪彬昺,姜成惠,杜一飞   

  1. 南京医科大学口腔疾病研究江苏省重点实验室,南京医科大学附属口腔医院口腔颌面外科 南京 210029
  • 出版日期:2016-11-01 发布日期:2016-11-01

Individual treatment of velopharygeal incomplete after palatoplasty

Li Sheng, Jiang Hongbing, Wan Linzhong, Yuan Hua, Wang Binbing, Jiang Chenghui, Du Yifei.   

  1. Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University; Dept of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing 210029, China
  • Online:2016-11-01 Published:2016-11-01

摘要: 目的 探讨腭裂术后腭咽闭合不全的个体化治疗方式。方法 对48例腭裂术后腭咽闭合不全患者进行病史回顾、查体、鼻咽纤维镜检查以及语音评估,根据检查结果分为3型。A型:腭咽闭合率在80%以上,软腭后缘距离咽后壁6 mm以内。B型:腭咽闭合率在80%以下,软腭短,咽侧壁动度较差。C型:腭咽闭合率在80%以下,软腭短,咽侧壁动度较好。对这3型患者分别采取不同的手术方式进行治疗。结果 所有48例患者经个体化手术治疗后,腭咽闭合率以及语音效果都得到明显改善和提高。结论 对腭裂术后腭咽闭合不全的患者,应在详细检查的基础上针对性地施行个体化手术治疗方案。

关键词: 腭咽闭合不全, 咽后壁瓣咽成形术, 腭咽肌瓣咽成形术

Abstract: Objective This study investigates the individual treatment of velopharyngeal incomplete(VPI) after palatoplasty. Methods Forty-eight patients with VPI were recruited. Physical examinations, including nasopharyngeal fiberscope examination, were performed on the basis of medical history. Patients were divided into three groups according to examination results. Group A comprised patients with velopharyngeal closure rate above 80% and slight distance between the posterior edge of the soft palate to the posterior wall. Group B comprised patients with velopharyngeal closure rate of less than 80%, shortened soft palate, and unobservable movement of the lateral pharyngeal wall. Group C comprised patients with velopharyngeal closure rate of less than 80%, shortened soft palate, and good movement of the lateral pharyngeal wall. Treatments for the three groups were designed differently. Results The speech results of all 48 patients significantly improved after individual surgical treatment. Conclusion Individual treatment plan should be designed on the basis of detailed examination in patients with VPI after palatoplasty.

Key words: velopharyngeal insufficiency, posterior pharyngeal flap pharyngoplasty, Sphincter pharyngoplasty

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[2] 张宇宁,曾妮,张焙,石冰,郑谦. 咽后壁瓣咽成形术对腭裂术后患者颌面部生长影响的初步研究[J]. 国际口腔医学杂志, 2023, 50(1): 66-71.
[3] 史佳虹, 鲁勇. 黏膜下腭裂的诊断及治疗[J]. 国际口腔医学杂志, 2018, 45(3): 368-372.
[4] 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.
[5] 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.
[6] 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.
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