提高腭瘘鼻腔面封闭成功率的临床体会

Modification of closuring nasal-layer of oronasal fistula

对24例腭瘘患儿行鼻腔面封闭时采用改变黏骨膜瓣的剥离顺序,先剥离瘘口周围切口另侧的原2大瓣黏骨膜瓣,见到腭骨后在可视情况下由腭骨表面往瘘口周围黏膜剥离,剥离子平行黏骨膜切缘剥离,保证瘘口周围的黏骨膜瓣完整、无破损,先缝合鼻腔面黏膜,然后缝合口腔面黏骨膜瓣。随访3～12月,24例全部成功。

24 patients with palatal fistula were treated by the modified operation. 2 big palatal mucoperiosteal island flaps around the fistula were stripped first. Then under the visualization of palate bone parallel to the incision the small mueoperisteal island flap peripheral to the fis- tula was stripped and the nasal-layer was closed by suture followed by suture of the palatal mucoperiosteal flaps. 3 - 12 month follow-up showed complete closure, of the oronasal fisutla in all the cases.