唇腭裂患者经上颌前方牵引治疗后其语音功能的影响研究

Influence of Maxillary Anterior Traction on the Articulatory Function in the Patients with Unilateral Cleft Lip and Palate

目的:比较唇腭裂术后患者经上颌前方牵引治疗反牙合前后语音功能的变化,研究前方牵引是否会对此类患者的语音功能产生影响。方法:根据纳入指标选取20例唇腭裂术后反牙合患者为实验组,采用上颌前方牵引;选取未经上颌前方牵引治疗的18例单纯牙性错牙合的同类患者为对照组,比较两组治疗前后的腭咽部气道情况、鼻音化率、腭咽闭合不全率的变化,统计分析唇腭裂患者经上颌前方牵引治疗后的语音功能变化。结果:治疗组前方牵引治疗后与治疗前比较,上气道腭咽部横截面积、矢状向测量指标均明显增大,差异具有统计学意义,冠状向各项测量指标差异无统计学差异;唇腭裂术后患者经过上颌前方牵引治疗后,鼻音化率由(65.00±3.28)%增加到(68.00±4.91)%,腭咽闭合不全率由(48.32±3.72)%增加到(52.19±4.31)%,差异具有统计学意义。结论:上颌前方牵引对单侧完全性唇腭裂患者上气道腭咽部狭窄改善明显,但伴随着腭咽部狭窄的改善,腭咽闭合功能减弱,表现为鼻音化率明显增加,腭咽闭合不全率明显升高。

Objective To compare the changes of articulatory function before and after maxillary anterior traction in patients with unilateral cleft lip and palate,and to study whether maxillary anterior traction will affect the articulatory function of these patients.Methods According to the inclusion criteria,20 patients with cleft lip and palate after operation were selected as the experimental group,the treatment method was maxillary anterior traction.18 patients with dental malocclusion were selected as the control group,treated without maxillary anterior traction.The changes of velopharyngeal airway,nasometer statistics and velopharyngeal incompetence rate were compared between the two groups before and after treatment,and the changes of articulatory function were statistically analyzed.Results In the experimental group,the cross-sectional area of upper airway palatopharynx and Sagittal measurement index were significantly increased after maxillary anterior traction treatment,and the difference was statistically significant.There was no significant difference in the measurement indexes of the coronal direction.After maxillary anterior traction,the nasometer statistics increased from(65.00±3.28)%to(68.00±4.91)%,and the velopharyngeal incompetence rate increased from(48.32±3.72)%to(52.19±4.31)%,the difference was statistically significant.Conclusion Maxillary anterior traction can significantly improve the upper airway velopharyngeal stenosis in patients with cleft lip and palate,at the same time,the velopharyngeal closure function is weakened,showing a significant increase in nasometer statistics and velopharyngeal incompetence rate.