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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Posterior pharyngeal flap for velopharyngeal insufficiency patients: a new technique for flap inset.
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Posterior pharyngeal flap for velopharyngeal insufficiency patients: a new technique for flap inset.

机译：咽后瓣治疗咽喉功能不全的患者：瓣修复的新技术。

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OBJECTIVES/HYPOTHESIS: To describe a modification of the originally described superiorly based pharyngeal flap as a secondary operation to correct velopharyngeal insufficiency (VPI) in patients with nonsyndromic repaired cleft palate. STUDY DESIGN: Prospective clinical trial at university medical center. METHODS: Twenty-six patients with VPI after cleft palate repair underwent a modified posterior pharyngeal flap procedure. Patients with submucous cleft palate or associated with syndromic VPI or Pierre Robin sequence were excluded from the study. Flap was harvested high up in the nasopharynx and inserted into the soft palate through a transverse full-thickness palatal incision. Lateral pharyngeal ports were determined by 45-degree nasoendoscopy. Speech assessment was done preoperatively and 3 months postoperatively. The flap integrity and lateral pharyngeal ports were evaluated with postoperative nasoendoscopy. RESULTS: Postoperative speech assessment showed significant improvement in the overall velopharyngeal function, nasal emission, resonance, and articulation defects. The pattern of velopharyngeal closure was circular in 15 patients, coronal in six patients, and sagittal in five patients. Eighteen patients received medium to wide flap, five patients had narrow flap, and three patients had near obstructing flap. Velopharyngeal function was normal or borderline insufficiency in 24 patients (92%). Partial flap dehiscence was seen in two patients and was considered as failure despite the significant improvement in their preoperative VPI. CONCLUSIONS: The minimal complication and ease of flap design with precise flap inset make this modified superior flap technique easily applicable with a high success rate for patients with VPI after cleft palate repair.
机译：目的/假设：描述对最初描述的基于优势的咽部皮瓣的修改，作为纠正非综合征性c裂患者的咽喉功能不全（VPI）的第二次手术。研究设计：大学医学中心的前瞻性临床试验。方法：对26例c裂修复后的VPI患者进行改良的后咽皮瓣手术。该研究排除了黏膜下left裂或伴有综合症状性VPI或Pierre Robin序列的患者。将皮瓣高高地收集在鼻咽处，并通过横向全厚度pa切口插入软pa。咽外侧口通过45度鼻内窥镜检查确定。术前和术后3个月进行言语评估。术后鼻内镜检查皮瓣完整性和咽侧口。结果：术后言语评估显示出整体咽喉功能，鼻腔分泌物，共振和咬合缺陷明显改善。咽喉闭合的模式为圆形15例，冠状6例，矢状5例。 18例患者接受了中到宽的皮瓣，5例患者的皮瓣狭窄，3例患者的皮瓣接近阻塞。 24例患者的咽喉功能正常或临界不全（92％）。尽管两名患者的术前VPI有了显着改善，但仍观察到部分皮瓣裂开，但仍被视为失败。结论：皮瓣设计简单，并发症少，并具有精确的皮瓣插入功能，使得这种改良的优质皮瓣技术很容易适用于c裂修复术后VPI患者，成功率很高。

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