同期咽后壁组织瓣转移修复后大龄腭裂患者语音改善效果的评价

目的探讨咽后壁瓣转移修复术对大龄腭裂患者语音效果的影响。方法选择2006年8月～2008年8月就诊于青岛大学医学院附属医院口腔颌面外科的大龄腭裂患者37例,20例采用两瓣法关闭裂隙并同期行咽后壁瓣转移修复术;17例单纯关闭裂隙。比较手术前后腭咽闭合不全率（RVPI）,单元音[i]三个共振峰频率,辅音[ka]、[pa]、[si]、[qi]冲直条和擦音乱纹及语音清晰度变化,并与健康儿童20例对照。结果所有患者均达到临床Ⅰ期愈合,两手术组术后RVPI均显著降低,语音也有不同程度改善,且关闭裂隙同期行咽后壁瓣转移修复术组明显优于单纯关闭裂隙组。结论大龄腭裂患者同期行腭裂修复术和咽后壁瓣转移修复术能显著改善患者的腭咽闭合功能,可作为大龄腭裂患者常规术式。

Evaluation of acoustic effects of cleft palate after posterior pharyngeal flap with simultaneous palatoplasty

Objective To evaluate acoustic effects of cleft palate patients aged over 8 years after posterior pharyngeal flap with simultaneous palatoplasty. Methods Thirty - seven cleft palate patients aged over 8 yeas from Aug 2006 to Aug 2008 presented to the Department of Oral and Maxillofaeial surgery, the Aflilitated Hospital of Qingdao University Medical College were included. Twenty patients were repaired by posterior pharyngeal flap with simultaneous two flaps, 17 were performed two flaps only. RVPI, the formant frequency of [i], the frequency of strike and fills of [ka], [ pa], [ si], [ qi] and speeeh intelligibility were compared between anterior and posterior surgery. Twenty normal ehildren were selected as control group. Results All patients showed clinical Ⅰ stage heal. The pronunciation and velopharyngeal closure of all patients was improved better by the simultaneous palatoplasty with posterior pharyngeal flap than palatoplasty only. Conclusion Posterior pharyngeal flapean markedly improved velopharyngeal competence （ VPC ） of deft palate patients aged over 8 years.