腭裂术后腭瘘的分类及其修复研究进展

腭瘘是腭裂术后最常见的并发症,影响患者的口腔卫生、语言功能及心理健康。目前腭瘘的定义及分类不尽相同,故腭瘘发生率的报道差异较大,发生率为0.8%~60%。本文对腭瘘的定义、分类及其修复方法进行综述。文献复习结果表明,目前缺少对腭瘘一致的定义及能全面反映腭瘘特点的分类法。腭瘘的修复方法有以下几种:邻近瓣主要用于穿孔<1 cm,且周围组织量足够的腭瘘修复;蒂在前的薄层舌背黏膜瓣是较大腭瘘的最常用方法;游离瓣主要适用于邻近瓣和带蒂都难以修复的顽固性及复杂的腭瘘;术中植入生物膜,形成3层封闭有助于减少创口复裂。离子体功能化电纺复合聚合物膜具有促血管形成作用,弹性及生物相容性良好,在动物模型上取得了良好的效果,但在人体上的安全性有待进一步研究。

Advances in classification and reconstruction of palatal fistula after cleft palate operation

Postoperative fistulae are one of the most significant complications of cleft palate repair.They usually has an adverse effect on patients’oral hygiene,speech and even mental health.There has been a wide range of rates of fis?tula occurrence,from 0.8%?60%,with the classification and definition of fistulae differing from one author to the next.In this paper,the definition and classification of palatal fistulae and their reconstruction method are reviewed.At pres?ent,there is a lack of a consistent definition of palatal fistulae and a classification that can fully reflect the characteris?tics of palatal fistula.Adjacent flap is mainly used for repairing small fistulae with an adequate amount of surrounding tissue;anteriorly based dorsal tongue flaps are a safe and reliable method for large fistulae;free flap is beneficial for re?fractory and complicated palatal fistulae that are difficult to repair by the local and pedicle flap;and different synthetic materials are used in multilayer repair of fistulae;among them,composite polymer membrane is highly biocompatible,promoting cell attachment and proliferation in animal models,but its security in the human body needs further research.