基于可吸收生物膜的软腭后退腭裂修复方案及其临床应用

目的:为解决常规腭裂修复术存在的问题,利用组织引导再生技术的原理,设计基于膜引导的腭裂整复方案,为需要后退软腭的腭裂修复提供新的途径或方法。方法:使用聚-DL-乳酸制成厚0.5mm、有一定强度与韧性的可吸收生物膜。先行软腭成形术,然后剖开硬腭裂隙边缘,于口腔侧骨膜瓣与腭骨水平板间形成一间隙,将膜植于其中并固定,利用膜的引导再生特性与桥梁支架作用,引导两侧软组织向中线生长而关闭裂隙。选择3-10岁需行软腭后退的腭裂患者19例,于全麻下行软腭后退成形术及硬腭裂隙植膜的临床试验,临床追踪观察6个月,了解腭裂修复的临床效果。结果:该腭裂修复方案切实可行,全部患者均按设计方案实施了腭裂修复术,方法简单,操作容易。3个月后19例患者均获临床一期愈合,6个月时临床观察软腭形态佳,腭咽闭合良好,达到腭裂硬腭软组织缺损修复、保证软腭充分后退的目的。结论:基于膜引导组织再生技术的后退软腭的腭裂修复方案,是一个创新的腭裂修复方案,手术操作简单、实用,临床效果满意,为腭裂修复提供了新的途径及方法。

Closure of hard cleft palate with guided tissue regeneration using absorbable membranes for clinical usage made by poly-DL-lactic acid:the new surgical method and its clinical application

PURPOSE: To solve the problems resulted from the traditional surgical repair methods for cleft palate, and take advantages of modern guided tissue regeneration technique, in order to provide a new pathway or method for cleft palate patients, a new surgical method was designed by using absorbable membranes for clinical usage made by poly-DL-lactic acid. METHODS: The absorbable membranes for clinical usage were made by poly-DL-lactic acid. The popular surgical procedure was taken at the soft palate and uvula, and then the absorbable membrane was implanted to the surgical gap between the periosteum and bone at the hard palate, and fixed with suture. 19 cleft palate patients, aged 3 to 10 years , were selected and underwent this surgical operation with implantation of the absorbable membranes. RESULTS: (1)This treatment plan and surgical method is useful and practical for repairing the cleft palate, and operations on all 19 patients were completed successfully, and it is simple and easy to take. 19 cleft palate patients acquired good clinical results. The completely clinical healing time was about 3 months late after operation and membranes implanted, and for6 months postoperation, clinical observation found shape and structure for soft palate and uvula was very pretty, and velopharyngeal closure was good as well. And the objective was achieved for hard cleft palate repair and soft palate pushback. CONCLUSION: It is a new and creative method for cleft palate repair by using the absorbable membrane with tissue guided regeneration technique up to now. This method is simple and practical with good clinical results for cleft palate repair. And it is beneficial for the cleft palate patients to take the surgical operation to close the cleft between oral cavity and nasal cavity and reconstruct the shape and structure for hard and soft palate.