Velopharyngeal closure function following modified unified velopharyngeal plasty performed by a single surgeon was evaluated pre- and postoperatively in 14 children with cleft palate after cleft palate closure and no ...Velopharyngeal closure function following modified unified velopharyngeal plasty performed by a single surgeon was evaluated pre- and postoperatively in 14 children with cleft palate after cleft palate closure and no improvement by speech training. Subjects were evaluated for velopharyngeal closure function before and after surgery at 1 (short-term evaluation) and 3 (mid-term evaluation) years. Degree of hypernasality and degree of air leakage through the nose in the soft blowing test were each classified into three grades and each grade was given scores. Velopharyngeal closure function was classified according to the total score into four grades: “good”, 'fair”, 'slightly poor” and “poor”. At the short-term evaluation, 11 patients (78.6%) achieved an improvement to “good” or “fair” on the overall evaluation. More satisfactory results were obtained at the mid-term evaluation, with 14 patients (100%) graded as “good” or “fair”. Our results indicate that this modified unified velopharyngeal plasty effectively improves velopharyngeal insufficiency when performed as a secondary surgery for cleft palate in children.展开更多
Background:Management of severe velopharyngeal dysfunction is best performed by a multispecialty team.This team could include a speech-language pathologist,otolaryngologist,prosthodontist,and a plastic surgeon.The mos...Background:Management of severe velopharyngeal dysfunction is best performed by a multispecialty team.This team could include a speech-language pathologist,otolaryngologist,prosthodontist,and a plastic surgeon.The most commonly performed surgical procedures in complicated cases with scarred soft palate are sphincter pharyngoplasty and pharyngeal flaps.In this study,a multidisciplinary approach was applied for proper assessment and surgical intervention using sphincter pharyngoplasty for velopharyngeal insufficiency after cleft palate repair.Methods:Twenty patients underwent sphincter pharyngoplasty.Preoperative diagnosis was performed using auditory perceptual assessment,nasoendoscopy assessment,nasometry,and videofluoroscopy.Results:There were statistically significant differences between the preoperative and postoperative assessments.Bleeding occurred in two patients.Obstructive sleep apnea occurred in three patients and was resolved spontaneously within three months,and one patient experienced slight wound dehiscence.Conclusion:Velopharyngeal dysfunction after cleft palate repair is best treated by a multidisciplinary team through speech therapy together with sphincter pharyngoplasty.展开更多
目的:探讨腭裂术后继发结构性语音障碍患者鼻音化率值与腭咽闭合状态的相关关系。方法:选择北京大学口腔医学院·口腔医院口腔颌面外科腭裂修复术后继发结构性语音障碍患者407个语音样本数据,应用鼻音计鼻音化率值及鼻咽纤维内镜腭...目的:探讨腭裂术后继发结构性语音障碍患者鼻音化率值与腭咽闭合状态的相关关系。方法:选择北京大学口腔医学院·口腔医院口腔颌面外科腭裂修复术后继发结构性语音障碍患者407个语音样本数据,应用鼻音计鼻音化率值及鼻咽纤维内镜腭咽闭合状态VAS值进行腭咽闭合功能评价。采用SPSS 13.0软件包对数据进行统计学分析。结果:407个语音样本数据鼻音化率值与VAS值呈现负相关倾向,腭咽闭合功能越差,鼻音化率值越高,296个数据具有显著相关性。其中,连续音节_([dadada])最敏感,各语音样本相关系数排序如下:R_([dadada])>R_([ta qu wu xi shi])>R_([sasasa])>R_([sisisi])>R_([dididi])>R_([papapa])>R_([i])>R_([pipipi])>R_([u])>R[wo dao hei long jiang]>R[a]。具有显著相关的296个数据依腭咽闭合状态分类统计,完全或边缘腭咽闭合鼻音化率值小于30%,轻度腭咽闭合不全鼻音化率值在30%~50%之间,中重度腭咽闭合不全鼻音化率值大于50%。结论:鼻音计应用特定语音样本,可初步提示腭裂术后继发结构性语音障碍的腭咽闭合状态,非鼻辅音的音节及语句具有较高的敏感性,单元音/a/和/u/敏感性较差。展开更多
文摘Velopharyngeal closure function following modified unified velopharyngeal plasty performed by a single surgeon was evaluated pre- and postoperatively in 14 children with cleft palate after cleft palate closure and no improvement by speech training. Subjects were evaluated for velopharyngeal closure function before and after surgery at 1 (short-term evaluation) and 3 (mid-term evaluation) years. Degree of hypernasality and degree of air leakage through the nose in the soft blowing test were each classified into three grades and each grade was given scores. Velopharyngeal closure function was classified according to the total score into four grades: “good”, 'fair”, 'slightly poor” and “poor”. At the short-term evaluation, 11 patients (78.6%) achieved an improvement to “good” or “fair” on the overall evaluation. More satisfactory results were obtained at the mid-term evaluation, with 14 patients (100%) graded as “good” or “fair”. Our results indicate that this modified unified velopharyngeal plasty effectively improves velopharyngeal insufficiency when performed as a secondary surgery for cleft palate in children.
文摘Background:Management of severe velopharyngeal dysfunction is best performed by a multispecialty team.This team could include a speech-language pathologist,otolaryngologist,prosthodontist,and a plastic surgeon.The most commonly performed surgical procedures in complicated cases with scarred soft palate are sphincter pharyngoplasty and pharyngeal flaps.In this study,a multidisciplinary approach was applied for proper assessment and surgical intervention using sphincter pharyngoplasty for velopharyngeal insufficiency after cleft palate repair.Methods:Twenty patients underwent sphincter pharyngoplasty.Preoperative diagnosis was performed using auditory perceptual assessment,nasoendoscopy assessment,nasometry,and videofluoroscopy.Results:There were statistically significant differences between the preoperative and postoperative assessments.Bleeding occurred in two patients.Obstructive sleep apnea occurred in three patients and was resolved spontaneously within three months,and one patient experienced slight wound dehiscence.Conclusion:Velopharyngeal dysfunction after cleft palate repair is best treated by a multidisciplinary team through speech therapy together with sphincter pharyngoplasty.
文摘目的:探讨腭裂术后继发结构性语音障碍患者鼻音化率值与腭咽闭合状态的相关关系。方法:选择北京大学口腔医学院·口腔医院口腔颌面外科腭裂修复术后继发结构性语音障碍患者407个语音样本数据,应用鼻音计鼻音化率值及鼻咽纤维内镜腭咽闭合状态VAS值进行腭咽闭合功能评价。采用SPSS 13.0软件包对数据进行统计学分析。结果:407个语音样本数据鼻音化率值与VAS值呈现负相关倾向,腭咽闭合功能越差,鼻音化率值越高,296个数据具有显著相关性。其中,连续音节_([dadada])最敏感,各语音样本相关系数排序如下:R_([dadada])>R_([ta qu wu xi shi])>R_([sasasa])>R_([sisisi])>R_([dididi])>R_([papapa])>R_([i])>R_([pipipi])>R_([u])>R[wo dao hei long jiang]>R[a]。具有显著相关的296个数据依腭咽闭合状态分类统计,完全或边缘腭咽闭合鼻音化率值小于30%,轻度腭咽闭合不全鼻音化率值在30%~50%之间,中重度腭咽闭合不全鼻音化率值大于50%。结论:鼻音计应用特定语音样本,可初步提示腭裂术后继发结构性语音障碍的腭咽闭合状态,非鼻辅音的音节及语句具有较高的敏感性,单元音/a/和/u/敏感性较差。
