咽后壁组织瓣转移术治疗先天性腭咽闭合功能不全的初步研究

Primary Study of Pharyngeal Flap Surgery in Congenital Velopharyngeal Insufficiency

目的初步研究咽后壁组织瓣转移手术治疗先天性腭咽闭合功能不全(CVPI)的疗效。方法选择29例CVPI患者施行蒂在上的咽后壁组织瓣转移术,手术前后由专业的语音病理师审听语音清晰度,同时行吹水泡试验,比较手术前后语音清晰度、异常语音和吹水泡试验的变化,并与20例正常语音者进行比较。结果29例CVPI患者的语音清晰度均值从术前的33.86%改善到术后的43.19%,吹水泡试验从术前的4.60 s提高至术后的17.72 s,经配对t检验,二者均有统计学差异(P<0.01),但患者术后的语音清晰度仍与正常者有较大差距。结论咽后壁组织瓣转移术可有效改善CVPI患者的腭咽闭合状况,减少鼻漏气,增加口腔内压,是治疗中极为重要的一步。

Objective To study effective operation method of congenital velopharyngeal insufficiency by reviewing clinical data of 29 patients with pharyngoplasfies . Methods 29 pafients （9 male and 20 female, ranged from 4 to 25 years old, meanagewas 13.5） with congenital velopharyngeal insufficiency were available for this study. All cases received Chinese speech intelligibility test and blowing test before and after the pharyngeal flap surgery. Results Chinese speech intelligibility of 29 cases who underwent pharyngoplasties was improved from 33.86% to 43.13%, and the blowing time was increased from 4.60 to 17.72 seconds, the degree of abnormal speech was reduced. Conclusion The pharyngeal flap surgery is an effective method for congenital velopharyngeal insufficiency, which reduces hypernasality and increases oral pressure, improves the velopharyngeal function.