Objective The aim of this study was to evaluate velopharyngeal function and speech outcomes of Sommerlad palatoplasty combined with sphincter pharyngoplasty in surgical repair of older patients with cleft palate. Methods 58 patients with cleft palate were managed between May 2013 and August 2017. 31 of them were treated with Sommerlad palatoplasty(S) combined with sphincter pharyngoplasty(SP) . Their ages ranged from 8.9 to 21.7 years (mean, 15.3 years). 18 of them are male and 13 are female. In control group, 27 patients were treated with Sommerlad palatoplasty. Patients’ ages ranged from 10.2 to 25.2 years (mean, 17.7 years). 16 of them are male and 11 are female. Evaluation of velopharyngeal function was conducted by means of cephalometric analyses, nasoendoscopy. Nasal resonance, nasal leakage, speech intelligibility were assessed by an experienced speech pathologist. Results The success rate of velopharyngeal competence was 61.3 % in S+SP group and 24.4 % in S group after surgical treatment(P＜0.05). There were statistic differences of nasal resonance,nasal leakage,speech intelligibility between the 2 groups(P＜0.05). Conclusion It has been suggested that the surgical approach with Sommerlad palatoplasty combined with sphincter pharyngoplasty has a high rate of success in surgical repair of older patients with cleft palate.%目的:探讨Sommerlad腭帆提肌重建术联合腭咽肌瓣咽成形术修复大龄患者腭裂的临床疗效,并观察术后对腭咽功能及语音效果的影响.方法:选择2013年5月-2017年8月在口腔颌面外科就诊的58例大龄腭裂患者为研究对象.实验组:31例,男18例,女13例,年龄(15.3±6.4)岁,均在全麻下行Sommerlad腭帆提肌重建联合腭咽肌瓣咽成形术修复;对照组:27例,其中男16例,女11例,年龄(17.7±7.5)岁,全麻下行Sommerlad腭帆提肌重建术修复.术后随诊6～36个月,采用头颅侧位X线片及鼻咽纤维镜检测腭咽功能,主观语音评估鼻腔共鸣、鼻漏气、语音清晰度.结果:所有患者创口愈合良好,实验组20例获得腭咽闭合,腭咽闭合率61.3%;对照组7例获得腭咽闭合,腭咽闭合率24.4%,两者之间比较有统计学差异(P＜0.05).实验组鼻腔共鸣、鼻漏气、语音清晰度症状改善程度优于对照组(P＜0.05).结论:Sommerlad腭帆提肌重建术联合腭咽肌瓣咽成形术同期修复大龄腭裂可提高术后的腭咽功能,改善语音效果.
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