腭后推上提和颊肌黏膜瓣修复10岁以上患者过宽腭裂

目的 探索修复10岁以上患者过宽腭裂畸形的手术方法.方法 通过腭后推、上提、腭大孔凿开、腭骨水平板凿断、双侧软腭后推、宋儒耀软腭上提术,结合一侧带蒂颊肌黏膜瓣转移修复过宽腭裂畸形.结果 2002年以来,运用该方法治疗13例10～25岁的腭裂患者,术后颊肌黏膜瓣完全成活,双侧软腭与咽后壁上提的组织瓣愈合良好,软、硬腭同时得到延长,腭咽闭合不全获得充分矫正,语音有明显改善,无腭瘘发生.结论 该方法具有无张力关闭过宽裂隙,软腭延长效果显著、持久,腭咽闭合效果良好,语音改善较明显的优点,尤其适合修复10岁以上患者过宽腭裂畸形.

Repair of the severe cleft palate in patients over 10 years old by soft palate plasty combined with buccal musculomucosal flap

OBJECTIVE: To investigate the repair of the severe cleft palate in patients over 10 years old. METHODS: First, the horizontal palate of the palatine bone was broken and the greater palatine foramen was enlarged by chisel. Then the great palatine neurovascular bundle was released. The soft palate was pushed back and lifted as described by Pro. Ruyao Song. Finally, a buccal musculomucosal flap was transferred to repair the frontal wound after pushing back the soft palate. RESULTS: 13 patients aged 10 - 25 years old were treated by this method. All the flaps survived completely. Both the hard and soft palate were lengthened. Velopharyngeal incompetence was corrected very well and the pronunciation improved markedly. CONCLUSIONS: This method can close the severe cleft palate without tension and lengthen the soft palate. It can correct velopharyngeal incompetence very well and improve pronunciation dramatically. It is especially useful for severe cleft palate in older patients.