大龄腭裂手术方式对语音效果的影响

Acoustic effects of surgical approaches on cleft palate in patients over 8 years old

目的:对大龄腭裂单纯行裂隙关闭术和同期行咽后壁咽成形术的患者术前、术后发音效果进行检测分析和对比,评定手术改善发音的治疗效果。方法:第四军医大学口腔医学院颌面外科2000-01/2004-06收治24例同期行腭裂关闭术及咽后壁组织瓣咽成形术治疗和22例单纯行裂隙关闭术的大龄腭裂患者,术前术后用鼻咽纤维镜检测其腭咽闭合情况,应用通用音频谱分析系统对腭裂语音进行声学分析。结果:所有腭裂修复术后创口均达到临床Ⅰ期愈合,语音也有不同程度改善。大龄腭裂患者采用腭裂关闭及同期咽成形术修复组,术后发音改善明显优于单纯行裂隙关闭组。结论:大龄腭裂患者采用腭裂关闭及同期咽成形术是提高腭咽闭合和改善发音的比较好的手术方法。

AIM:To examine and compare the preoperative and postoperative acoustic outcomes of patients with cleft palate following simple palatorrhaphy and simultaneous palatorrhaphy with posterior pharyngeal flap transplantation,and evaluate the pronunciation improvement by operations. METHODS:In the Department of Oral and Maxillofacial Surgery,Stomatological College,Fourth Military Medical University,24 cleft palate inpatients were repaired by simultaneous palatorrhaphy with posterior pharyngeal flap transplantation,and another 22 were repaired by palatorrhaphy only between January 2000 and June 2004.Fibrescope of nasopharynx was used to detect velopharyngeal closure in all the patients preoperatively and postoperatively,and acoustic spectral analysis system to acoustically analyze pronunciation in patients with cleft palate. RESULTS:All the wounds healed at clinical stage Ⅰafter palatorrhaphy.The pronunciation of all the patients was improved after operation.The postoperative acoustic improvement after repair of cleft palate by simultaneous palatorrhaphy with posterior pharyngeal flap transplantation in the patients over 8 years old was remarkably better than that after repair of cleft palate by simple palatorrhaphy. CONCLUSION:The simultaneous palatorrhaphy with posterior pharyngeal flap transplantation for the repair of cleft palate in patients over 8 years old improves velopharyngeal closure and pronunciation better than palatorrhaphy only does.