腭裂术后腭咽闭合不全患者面部扭曲行为与腭咽闭合程度的关系

Study on Relationship between Facial Grimace and Velopharyngeal Closure Ratios in Patients with Velopharyngeal Insufficiency after Cleft Palate Surgery

目的:探究腭裂术后腭咽闭合不全患者面部扭曲行为与腭咽闭合程度之间的关系。方法:收集2020年9月~2023年1月68例腭裂术后患有腭咽闭合不全患者的临床资料、语音评估视频资料,分析其鼻漏气特点与面部扭曲情况,通过鼻咽镜视频资料分析并计算腭咽闭合程度。结果:36例(52.9%)患者存在面部扭曲行为,面部扭曲患者鼻翼肌肉运动变化较无面部扭曲患者更大,差异有统计学意义(P<0.05)。患有不可闻及鼻漏气、可闻及鼻漏气、鼻湍流的患者呈现面部扭曲的比例为7例(35.0%)、24例(75.0%)、5例(31.3%),差异有统计学意义(P<0.05)。面部扭曲出现在轻度、中度、重度腭咽闭合不全的比例为7例(38.9%)、25例(73.5%)、4例(25.0%),差异有统计学意义(P<0.05)。结论:面部扭曲发生率在患有可闻及鼻漏气的腭咽闭合不全患者中较高,呈现面部扭曲的患者可能患有中度腭咽闭合不全。

Objective:To explore the relationship between facial grimace and velopharyngeal closure ratios in patients with velopharyngeal insufficiency after cleft palate surgery.Methods:Medical records and speech evaluation videos of 68 patients from September 2020 to January 2023 with velopharyngeal insufficiency after cleft palate surgery were collected.The characteristics of nasal air emission and facial grimace were analyzed.The degree of velopharyngeal closure ratios was analyzed and calculated through videos of nasopharyngeal fiberscope.Results:Thirty-six(52.9%)patients showed the incidence of facial grimace,the change of alar muscle movement in patients with facial grimace was greater than that in patients without facial grimace.The proportion of patients with inaudible nasal air emission,audible nasal emission,and nasal turbulence presenting facial grimace was 7(35.0%),24(75.0%),and 5(31.3%),which had statistically difference(P<0.05).The proportion of facial grimace in mild,moderate,and severe velopharyngeal insufficiency was 7(38.9%),25(73.5%),and 4(25.0%),which had statistically difference(P<0.05).Conclusion:The incidence of facial grimace was higher in patients with audible nasal air emission with velopharyngeal insufficiency.Patients who showed facial grimace may have moderate velopharyngeal insufficiency.