Furlow反向双Z法与Sommerlad腭帆提肌重建术修复腭裂患者术后腭咽功能和语音效果的比较研究
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河北省重点研发计划项目(20377747D);


Clinical study of Furlow double-opposing Z-plasty and Sommerlad levator veli palatini reconstruction on postoperative velopharyngeal function and speech effect in the repair of patients with cleft palate
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    摘要:

    目的:比较Furlow反向双Z法与腭帆提肌重建术修复腭裂术后腭咽闭合不全(VPI)的效果。方法:回顾性分析94例腭裂术后VPI患者的临床资料,采用Furlow反向双Z法的患者为Furlow组(n=45);采用Sommerlad腭帆提肌重建术的患者为Sommerlad组(n=49)。术后均随访12个月,比较两组患者语音清晰度、鼻腔共鸣和鼻漏气、腭咽功能改善情况。结果:术后12个月,Sommerlad组与Furlow组的腭咽闭合率无统计学差异(P>0.05);两组患者语音清晰度、鼻腔共鸣恢复程度均高于术前(P<0.05),且Furlow组均高于Sommerlad组(P<0.05)。两组患者术后鼻漏气可闻及率均低于术前(P<0.05),且Sommerlad组鼻漏气可闻及率低于Furlow组(P<0.05)。结论:Furlow反向双Z法对腭裂术后VPI语音效果语音清晰度、鼻腔共鸣改善效果理想,而Sommerlad腭帆提肌重建术对鼻漏气可闻及率改善更理想,二者均能一定程度改善腭咽功能,临床应根据患者实际情况选择术式。

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    Objective:To explore the effect of different surgical methods on the repair of velopharyngeal insufficiency(VPI)af-ter cleft palate surgery.Methods:The clinical data of 94 patients with VPI after cleft palate surgery were retrospectively analyzed.45 patients who received Furlow double-opposing Z-plasty were included in Furlow group,and 49 patients who adopted Sommerlad levator veli palatini reconstruction were enrolled as Sommerlad group.The patients were followed up for 12 months after surgery,and the im-provement conditions of speech intelligibility,nasal resonance,nasal air leakage and velopharyngeal function were analyzed.Results:At 12 months after surgery,there was no statistically significant difference in the velopharyngeal closure rate between the Sommerlad group and the Furlow group(P>0.05).The speech intelligibility and nasal resonance recovery degree in the Furlow group and the Sommer-lad group were better than those before surgery,and the above indicators in the former group were higher than those in the latter group(P<0.05).The audibility rate of postoperative nasal leakage in the Furlow group and the Sommerlad group was lower than that before surgery,and the audibility rate in the latter group was lower than that in the former group(P<0.05).Conclusion:Furlow double-op-posing Z-plasty for VPI after cleft palate surgery is more ideal in improving speech intelligibility and nasal resonance,while Sommerlad palatoplasty demonstrated superior improvement in speech outcomes and reduced nasal air emission rates compared to conventional tech-niques,with both parameters contributing to enhanced velopharyngeal function.Clinically,it is necessary to select the surgical method according to the actual situation of patients.

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古加伟;李瑾;李小东;孙磊磊;黄威;. Furlow反向双Z法与Sommerlad腭帆提肌重建术修复腭裂患者术后腭咽功能和语音效果的比较研究[J].川北医学院学报,2025,40(5):585-588.

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  • 在线发布日期: 2025-07-09
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