双颊肌黏膜瓣修复大龄宽大腭裂患者的远期效果评价.docVIP

双颊肌黏膜瓣修复大龄宽大腭裂患者的远期效果评价 双颊肌黏膜瓣修复大龄宽大腭裂患者的远期效果评价 作者：肖水生 郁葱 刘平 作者单位：1.重庆医科大学附属口腔医院 颌面外科；2.麻醉科，重庆 400015 【摘要】 　　目的 对采用双颊肌黏膜瓣修复的大龄宽大腭裂患者的语音效果和上颌骨发育情况进行分析，评价手术的远期效果。方法 选择12例大龄宽大腭裂患者为试验组，采用软腭后退双颊肌黏膜瓣修复；同期选择20例腭裂患者为传统手术组，采用常规双瓣法加软腭肌功能修整术进行整复；另外选择30例非唇腭裂患者作为对照组。应用专业语音和临床语音评价方法比较腭裂患者术前和术后5年的语音效果；拍摄头颅定位侧位片，应用头影测量方法评价患者术前和术后5年的上颌骨发育情况；并将2组腭裂患者术后5年的语音和上颌骨发育情况与对照组进行比较。结果 试验组患者术后伤口均达到一期愈合；随访5年，张口度正常，硬软腭部无继发穿孔，原手术区域组织松软，组织瓣较腭部组织色泽红润。试验组术后语音效果优于术前，也优于传统手术组（P0.05）；术后上颌骨发育情况优于传统手术组（P0.05），但与对照组相比无明显差异（P0.05）。结论 采用软腭后退双颊肌黏膜瓣法修复大龄宽大腭裂患者，术后语音改善效果较好，对上颌骨发育的影响较小，是一种较好的手术方式。 【关键词】 腭裂 双颊肌黏膜瓣 上颌骨发育 语音 　　A long-term evaluation of bibuccinator myomucosal island flap applying to elder patients suffered from wide cleft palate XIAO Shui-sheng1, YU Cong2, LIU Ping1. （1. Dept. of Oral and Maxillofacial Surgery, TheStomatological Hospital of Chongqing Medical University, Chongqing 400015, China; 2. Dept. of Anesthesiology, The Stomatological Hospital of Chongqing Medical University, Chongqing 400015, China） 　　[Abstract] Objective To evaluate a long-term effect on pronunciation and maxillary growth of elder patients with wide isolated cleft palate after bibuccinator myomucosal island flap palatoplasty. Methods Twelve patients over eight years old with wide isolated cleft palate were selected in experiment group, who received bibuccinator myomucosalisland flap palatoplasty. The common group comprised 20 age-matched patients with isolated cleft palate receiving traditional palatoplasty named double-flap method. Simultaneously, 30 randomly selected age-matched noncleft childrenwere included in control group. Both preoperative and postoperative effects over five years on pronunciation and maxillary growth were evaluated using professional, clinical pronunciation system and cephalometric measurement between former two groups. The data of former two groups were compared with control group statistically. Results The incisions of all patients in experiment group hea