国际口腔医学杂志

国际口腔医学杂志 ›› 2021, Vol. 48 ›› Issue (6): 640-643.doi: 10.7518/gjkq.2021062

• 论著 • 上一篇    下一篇

腭裂裂隙宽度与Sommerlad-Furlow法修复腭裂术后腭瘘发生率的关联研究

吴敏(),李承浩,李扬,龚彩霞,石冰()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院唇腭裂外科 成都 610041
  • 收稿日期:2021-02-11 修回日期:2021-06-15 出版日期:2021-11-01 发布日期:2021-10-28
  • 通讯作者: 石冰
  • 作者简介:吴敏,主管护师,学士,Email： min-min-1984@163.com
  • 基金资助:
    四川大学华西口腔医院探索与研发项目(LCYJ2019-10)

Effect of preoperative width of cleft palate on fistula formation after Sommerlad-Furlow technique

Wu Min(),Li Chenghao,Li Yang,Gong Caixia,Shi Bing()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2021-02-11 Revised:2021-06-15 Online:2021-11-01 Published:2021-10-28
  • Contact: Bing Shi
  • Supported by:
    Research and Development Program, West China Hospital of Stomatology, Sichuan University(LCYJ2019-10)

RichHTML

6

PDF (PC)

606

摘要：

目的 研究腭裂软硬腭的最宽处裂隙宽度对Sommerlad-Furlow法（简称SF法）修复腭裂术后腭瘘发生率的影响。方法 对四川大学华西口腔医院唇腭裂外科2017年4月—2018年12月373例8~18月龄的行SF法一期腭裂硬腭无松弛切口术后患者的伤口进行观察,半年后随访,研究患者的腭瘘率。研究腭裂修复术后影响腭瘘的因素,观察指标为性别、年龄、手术医生、腭裂软硬腭的最宽处宽度和软硬腭的最宽处裂隙宽度/上颌结节后缘平面宽度。结果 采用SF法腭裂修复术的总瘘孔率为6%。患者性别、年龄和手术医生在腭瘘发生率中差异无统计学意义（P>0.05）。将腭裂软硬腭的最宽处宽度裂隙分为4组：<5 mm裂隙宽度的患者18例,其中发生腭瘘0例;5~10 mm裂隙宽度的患者204例,发生腭瘘9例;10~15 mm裂隙宽度的患者137例,发生腭瘘11例;>15 mm裂隙宽度的患者14例,发生腭瘘3例。腭瘘发生率与腭裂裂隙宽度差异有统计学意义（P=0.048）。结论 在新的修复技术下,腭裂术后腭瘘的发生与腭裂裂隙宽度和腭裂软硬腭的最宽处裂隙宽度/上颌结节后缘平面宽度的占比有相关性。

关键词: 腭裂, 裂隙宽度, 腭瘘, Sommerlad-Furlow法

Abstract:

Objective This study aimed to evaluate the association between postoperative palatal fistula formation and the ratio of cleft width to the sum of palatal-shelf width by using the Sommerlad-Furlow technique (SF technique for short) for primary palate repair. Methods A total of 373 patients aged 8-18 months who underwent Huaxi SF technique for primary cleft palate without relaxation incision from April 2017 to December 2018 were included in the study. The incidence of palatal fistula was followed up 6 months after surgery. Gender, age, surgeon’s qualification, and the ratio of cleft width to the sum of palatal-shelf width were considered as the potential factors for affecting palatal fistula formation. Results The effect of gender, age, and surgeon’s qualification had no statistical significance (P>0.05). The effect of the ratio of cleft width to the sum of palatal-shelf width on postoperative fistula formation showed a strong association (P=0.048), with a width <5 mm (18 patients, no palatal fistula), from 5 mm to 10 mm (204 patients, 9 with palatal fistula), from 10 mm to 15 mm (137 patients, 11 with palatal fistula), and a cleft width >15 mm (14 patients, 3 with palatal fistula). Conclusion This study confirmed that the occurrence of palatal fistula was closely related to the preoperative cleft width repaired through the SF technique.

Key words: cleft palate, cleft width, palatal fistula, Sommerlad-Furlow technique

中图分类号: 

  • R782.2+2

表1

不同腭裂裂隙宽度的腭瘘率"

裂隙宽度组别/mm 患者例数/例 腭瘘例数
（腭瘘率/%）		 P值
<5 18 0（0） 0.048
5~10 204 9（4）
10~15 137 11（8）
>15 14 3（21）
[1] Muzaffar AR, Byrd HS, Rohrich RJ, et al. Incidence of cleft palate fistula: An institutional experience wi-th two-stage palatal repair[J]. Plast Reconstr Surg, 2001, 108(6):1515-1518.
pmid: 11711920
[2] Salimi N, Aleksejūnienė J, Yen EHK, et al. Fistula in cleft lip and palate patients-a systematic scoping review[J]. Ann Plast Surg, 2017, 78(1):91-102.
doi: 10.1097/SAP.0000000000000819
[3] Ogata H, Sakamoto Y, Kishi K. Cleft palate repair without lateral relaxing incision[J]. Plast Reconstr Surg Glob Open, 2017, 5(3):e1256.
doi: 10.1097/GOX.0000000000001256
[4] Lithovius RH, Ylikontiola LP, Sándor GK. Incidence of palatal fistula formation after primary palatoplasty in northern Finland[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2014, 118(6):632-636.
doi: 10.1016/j.oooo.2014.07.002
[5] 王龑, 李承浩. 唇腭裂手术治疗[M]. 北京: 人民军医出版社, 2015: 129-132.
Wang Y, Li CH. Cleft lip and palate surgery[M]. Beijing: People’s Military Medical Press, 2015: 129-132.
[6] Isogawa N, Ochiai S, Mito T, et al. Three-dimensional comparison in palatal forms between modified presurgical nasoalveolar molding plate and hotz’s plate applied to the infants with unilateral cleft lip and palate[J]. Singapore Dent J, 2010, 31(1):36-42.
doi: 10.1016/S0377-5291(12)70008-1
[7] Darvann TA, Hermann NV, Ersbøll BK, et al. Palatal surface area of maxillary plaster casts: a comparison between two-dimensional and three-dimensio-nal measurements[J]. Cleft Palate Craniofac J, 2007, 44(4):381-390.
doi: 10.1597/05-213.1
[8] 柳春明, 梁立民, 宋儒耀, 等. 骨缝牵引成骨修复腭裂的临床初步研究[J]. 中华整形外科杂志, 2003, 19(4):261-264.
Liu CM, Liang LM, Song RY, et al. Sutural distrac-tion osteogenesis for primary cleft palate repair: a preliminary clinical report[J]. Chin J Plast Surg Burns, 2003, 19(4):261-264.
[9] 秦永平, 王春燕, 赵振民. 腭瘘的发病与修复进展[J]. 中国美容医学, 2008, 17(8):1246-1249.
Qin YP, Wang CY, Zhao ZM. The morbidity and re-pair advancement of palate fistula[J]. Chin J Aesthe-tic Med, 2008, 17(8):1246-1249.
[10] Maeda K, Ojimi H, Utsugi R, et al. A T-shaped musculomucosal buccal flap method for cleft palate surgery[J]. Plast Reconstr Surg, 1987, 79(6):888-896.
pmid: 3588727
[11] Senders CW, Sykes JM. Modifications of the Furlow palatoplasty (six- and seven-flap palatoplasties)[J]. Arch Otolaryngol Head Neck Surg, 1995, 121(10):1101-1104.
doi: 10.1001/archotol.1995.01890100017003
[12] Inman DS, Thomas P, Hodgkinson PD, et al. Oro-nasal fistula development and velopharyngeal insufficiency following primary cleft palate surgery: an audit of 148 children born between 1985 and 1997[J]. Br J Plast Surg, 2005, 58(8):1051-1054.
pmid: 16084930
[13] Phua YS, de Chalain T. Incidence of oronasal fistulae and velopharyngeal insufficiency after cleft pa-late repair: an audit of 211 children born between 1990 and 2004[J]. Cleft Palate Craniofac J, 2008, 45(2):172-178.
doi: 10.1597/06-205.1
[14] Lu Y, Shi B, Zheng Q, et al. Incidence of palatal fistula after palatoplasty with levator veli palatini retropositioning according to Sommerlad[J]. Br J Oral Maxillofac Surg, 2010, 48(8):637-640.
doi: 10.1016/j.bjoms.2009.10.018
[15] Landheer JA, Breugem CC, van der Molen AB . Fistula incidence and predictors of fistula occurrence after cleft palate repair: two-stage closure versus one-stage closure[J]. Cleft Palate Craniofac J, 2010, 47(6):623-630.
doi: 10.1597/09-069
[16] Schultz RC. Management and timing of cleft palate fistula repair[J]. Plast Reconstr Surg, 1986, 78(6):739-747.
pmid: 3538077
[17] Amaratunga NA. Occurrence of oronasal fistulas in operated cleft palate patients[J]. J Oral Maxillofac Surg, 1988, 46(10):834-838.
doi: 10.1016/0278-2391(88)90044-4
[18] Andersson EM, Sandvik L, Semb G, et al. Palatal fistulas after primary repair of clefts of the secon-dary palate[J]. Scand J Plast Reconstr Surg Hand Surg, 2008, 42(6):296-299.
doi: 10.1080/02844310802299676
[19] MacKay D, Mazahari M, Graham WP, et al. Incidence of operative procedures on cleft lip and palate patients[J]. Ann Plast Surg, 1999, 42(4):445-448.
doi: 10.1097/00000637-199904000-00017
[20] Pulkkinen J, Haapanen ML, Paaso M, et al. Velopharyngeal function from the age of three to eight years in cleft palate patients[J]. Folia Phoniatr Logop, 2001, 53(2):93-98.
doi: 10.1159/000052659
[21] Cohen SR, Kalinowski J, LaRossa D, et al. Cleft palate fistulas: a multivariate statistical analysis of prevalence, etiology, and surgical management[J]. P-last Reconstr Surg, 1991, 87(6):1041-1047.
[22] Parwaz MA, Sharma RK, Parashar A, et al. Width of cleft palate and postoperative palatal fistula: do they correlate[J]. J Plast Reconstr Aesthet Surg, 2009, 62(12):1559-1563.
doi: 10.1016/j.bjps.2008.05.048 pmid: 18838320
[1] 毛奇蓉,尹恒,李精韬. 边缘性腭咽闭合不全临床诊疗研究进展[J]. 国际口腔医学杂志, 2024, 51(1): 116-124.
[2] 夏溦瑶,贾仲林. 维生素与唇腭裂发生相关性的研究进展[J]. 国际口腔医学杂志, 2023, 50(6): 632-638.
[3] 万雪丽,石永乐,张秀芬,王欢,田莉. 唇腭裂患儿全身麻醉苏醒期躁动多维干预体系的构建研究[J]. 国际口腔医学杂志, 2023, 50(3): 272-278.
[4] 陈卓,石冰,李精韬. 唇腭裂患者外鼻生长特征的研究进展[J]. 国际口腔医学杂志, 2023, 50(3): 279-286.
[5] 石佳鑫,王淳艺,李精韬. Pierre Robin序列征患者腭裂临床治疗的研究进展[J]. 国际口腔医学杂志, 2023, 50(2): 237-242.
[6] 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.
[7] 裴玲,曾妮,杨超,何苗,罗强,石冰,郑谦. 辅助局部麻醉对唇腭裂整复术后镇痛效果的研究[J]. 国际口腔医学杂志, 2022, 49(6): 657-662.
[8] 黄艺璇,石冰,李精韬. 唇腭裂患者鼻通气功能的研究进展[J]. 国际口腔医学杂志, 2022, 49(4): 453-461.
[9] 罗枭,蔡生青,石冰,李承浩. 2,3,7,8-四氯二苯二噁英诱导C57BL小鼠腭裂发病机制的研究[J]. 国际口腔医学杂志, 2022, 49(3): 317-323.
[10] 张琦,范存晖,杨茜,李然,徐晓琳,丁玮,王文惠,杨彩秀. 替牙期骨性Ⅲ类单侧完全性唇腭裂与非唇腭裂患者牙弓形态的对比研究[J]. 国际口腔医学杂志, 2022, 49(2): 144-152.
[11] 孙嘉琳,林岩松,石冰,贾仲林. 5种常见综合征型唇腭裂遗传学研究进展[J]. 国际口腔医学杂志, 2021, 48(6): 718-724.
[12] 马晓芳,黄永清,石冰,马坚. 双生子模型在唇腭裂病因学研究中的应用[J]. 国际口腔医学杂志, 2021, 48(5): 512-519.
[13] 尹恒. 黏膜下腭裂的语音评估与治疗建议[J]. 国际口腔医学杂志, 2021, 48(3): 259-262.
[14] 艾皮孜古丽·亚库普,亚尔肯·阿吉,吴言辉,路利丹,许辉. 腭裂术后患者发音时表情扭曲与构音的关系研究[J]. 国际口腔医学杂志, 2021, 48(3): 263-268.
[15] 吴敏,石冰. 唇腭裂婴儿母乳喂养的研究进展[J]. 国际口腔医学杂志, 2021, 48(3): 269-273.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] 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): .
[2] 王昆润. 长期单侧鼻呼吸对头颅发育有不利影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[3] 彭国光. 颈淋巴清扫术中颈交感神经干的解剖变异[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 杨凯. 淋巴化疗的药物运载系统及其应用现状[J]. 国际口腔医学杂志, 1999, 26(05): .
[5] 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): .
[6] 柴枫. 可摘局部义齿用Co-Cr合金的激光焊接[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 孟姝,吴亚菲,杨禾. 伴放线放线杆菌产生的细胞致死膨胀毒素及其与牙周病的关系[J]. 国际口腔医学杂志, 2005, 32(06): 458 -460 .
[8] 费晓露,丁一,徐屹. 牙周可疑致病菌对口腔黏膜上皮的粘附和侵入[J]. 国际口腔医学杂志, 2005, 32(06): 452 -454 .
[9] 赵兴福,黄晓晶. 变形链球菌蛋白组学研究进展[J]. 国际口腔医学杂志, 2008, 35(S1): .
[10] 庞莉苹,姚江武. 抛光和上釉对陶瓷表面粗糙度、挠曲强度及磨损性能的影响[J]. 国际口腔医学杂志, 2008, 35(S1): .