大龄腭裂患者治疗模式的初步研究

目的改进大龄腭裂患者的治疗模式，提高大龄腭裂患者术后的腭咽闭合率和语音清晰度。方法对37例年龄大于6岁（含6岁）的腭裂患者进行同期腭裂与腭咽肌瓣咽成形整复术，并对其术后10~15个月的效果进行了随访和语音评估。结果22例患者术后腭咽闭合完全，15例术后虽仍有腭咽闭合不全，但在鼻咽纤维镜下腭咽闭合度达85%以上；所有患者X线侧位咽腔造影显示软腭与咽后壁贴合；语音检测显示，高鼻音和鼻漏气程度显著下降，辅音清晰度提高。结论本研究中建立的大龄腭裂患者治疗模式可以显著提高腭裂患者术后的腭咽闭合率和语音清晰度，为改善其生存质量创造了条件。

Investigation of the optimized surgical procedure for the cleft palate patients over six years old

Objective To establish the optimized surgical procedure in our approach to treat the velopharyngeal insufficiency and improve the articulations of the patients with cleft palate over six years old. Methods Thirty-seven subjects over six years（including six years） old underwent the palatoplasty and sphincter pharyngoplasty simulta - neously. We assessed the outcome of the surgery by perceptual speech assessment, nasopharyngoscopy and lateral cephalogram 10 to 15 months postoperatively. Results Twenty-two subjects got complete velopharyngeal closure. The velopharyngeal closure ratio of 15 subjects were over 85% according to the findings of the nasopharyngoscopy. Lateral cephalograms reveal that all the subjects could get their velars raised and well contacted with the posterior pharyngeal wall in dynamic condition. Perceptual speech assessment: The rate of hypernasality and nasal emission decreasedsignificantly, and the consonant articulation increased. Conclusion Our surgical procedure in this study corrected the velopharyngeal insufficiency and improved the articulation of the patients over six years old significantly.