腭裂的嗓音治疗幻灯片.ppt

Symptom Nasal regurgitations during bottle feeding（喂奶时鼻腔返流） squeeze the bottle in conjunction with the babys sucking/breathing rhythm to assist with swallowing part 6 Repair * the goal * the age * the procedures Repair The goal: to create a velopharyngeal valving mechanism that is capable of seperating the oral from the nasal cavities during speech. [primary goal] added benefits: easier intake of food, reduction in the number of upperrespiratory infections, and improvment to the status of the middle ear. for parents: experience a psychological lift when the cleft is repaired Repair The age: The optimal timing for cleft palate repair is controversial. early late advantages better speech development and less hearing loss better facial growth disadvatages impair facial growth - nasal growth and palatal growth can be restricted with early repair Poor speech and hearing outcomes a two-stage repair has been proposed. Involves: * closure of the soft palate between 6 to 12 m [ creates a functional palate, reduces the chances that fluid will develop in the middle ears, and aids in the proper development of the teeth and facial bones ] * closure of the hard palate between 15 to 18 m With this approach, the part of the palate necessary for normal speech development is intact, but without the growth restriction of closing the hard palate. * In China: most commonly at 1.5 to 2 years old.【体重在12公斤以上，WBC（白细胞）在10,000以下，血红蛋白在10克以上，无发热﹑咳嗽﹑流鼻涕现象。】 Repair How: before the surgery: # a speech therapist or feeding therapist -- feed the child to gain weight and be healthy # test blood / take medical history / physical examinations # 10 days before: stop taking some drugs like Aspirin # on the day: arrive on time / give a small sip of water / make sure the childs health Repair How: during the surgery: 2 or 3 hours: # have general anesthesia (asleep and not feeling pain)（全身麻醉） # two main types of the surgery: * palatoplasty（腭成形术） * pharyngoplasty（咽成形术） Bo