颊脂肪垫在腭裂修复术中的应用及其对腭咽闭合功能的影响

Application of the Buccal Fat Pad in Cleft Palate Repair and Assessment of Velopharyngeal Function

目的:探讨颊脂肪垫(BFP)在腭裂修复中的应用,并提高腭裂修复的手术效果。方法:选取80例腭裂患者,根据随机双盲、数字表分配法,单数为应用BFP组(实验组,提肌重建联合BFP充填),双数为对照组(提肌重建),各组40例。术后观察创面愈合情况,1、3、6、12个月回访,行语音评估,电子鼻咽镜行腭咽闭合功能检查,对于因年龄小无法配合者,待其5周岁左右进行。结果:实验组创面愈合较好,无腭瘘,对照组2例腭瘘。实验组腭部瘢痕不显、语音清晰度优于对照组。结论:在腭裂修复中用BFP能减少软硬腭交界区腭瘘发生及减轻术区瘢痕,改善软腭活动度,提升腭咽闭合率,具有临床推广运用价值。

Objective： To discuss the application ofbuccal fat pad （BFP） in cleft palate repair, and to promote the operation effect of cleft palate. Methods： Eighty patients with cleft palate by a randomised, double blind study were divided into experimental（levator veli palatini retropositioning combined with BFP）and control（levator veli palatine retroposi- tioning） groups, 40 cases in each group. The wound healing was Observed and followed up after 1, 3, 6 and 12 months to assess speech outcome. Results： There was no palate fistula occurred, and less scar contracture of the soft palate and better speech outcome were observed in the experimental group compared to the control group （2 cases of palate fistula）. Conclusion： The application of BFP in the cleft palate repair can significantly reduce the occurrence of palate fistula, minimize the scar contracture and promote the velopharyngeal function.