腭咽闭合不全的个体化治疗策略

Individual treatment of vclopharygeal incomplete after palatoplasty

目的探讨腭裂术后腭咽闭合不全的个体化治疗方式。方法对48例腭裂术后腭咽闭合不全患者进行病史回顾、查体、鼻咽纤维镜检查以及语音评估,根据检查结果分为3型。A型:腭咽闭合率在80%以上,软腭后缘距离咽后壁6 mm以内。B型:腭咽闭合率在80%以下,软腭短,咽侧壁动度较差。C型:腭咽闭合率在80%以下,软腭短,咽侧壁动度较好。对这3型患者分别采取不同的手术方式进行治疗。结果所有48例患者经个体化手术治疗后,腭咽闭合率以及语音效果都得到明显改善和提高。结论对腭裂术后腭咽闭合不全的患者,应在详细检查的基础上针对性地施行个体化手术治疗方案。

Objective This study investigates the individual treatment of velopharyngeal incomplete（VPI） after palatoplasty. Methods Forty-eight patients with VPI were recruited. Physical examinations, including nasopharyngeal fiberscope examination, were performed on the basis of medical history. Patients were divided into three groups according to examination results. Group A comprised patients with velopharyngeal closure rate above 80% and slight distance between the posterior edge of the soft palate to the posterior wall. Group B comprised patients with velopharyngeal closure rate of less than 80%, shortened soft palate, and unobservable movement of the lateral pharyngeal wall. Group C comprised patients with velopharyngeal closure rate of less than 80%, shortened soft palate, and good movement of the lateral pharyngeal wall. Treatments for the three groups were designed differently. Results The speech results of all 48 patients significantly improved after individual surgical treatment. Conclusion Individual treatment plan should be designed on the basis of detailed examination in patients with VPI after palatoplasty.