【摘要】 目的:分析腭裂术后腭咽闭合不全(VPI)患者成年期腭咽结构形态特征与腭咽功能之间的关系。方法:应用回顾性研究的方法对23例初期腭成形术后腭咽闭合不全患者(年龄16～36岁,平均年龄18.3岁,男10例,女13例,男∶女=1∶1.3)与20例健康对照组(年龄在16～24岁,平均年龄18.6岁,男∶女=0.82∶1)分别拍摄静止时的X线头颅侧位定位片,比较2组间软腭长度、咽腔深度、咽腔高度、adequateratio=软腭长度/咽腔深度的差异;分析咽三角(由翼颅基点,第一颈椎,后鼻棘构成)以及软腭与咽后壁相接触点(PPW)在咽三角的位置关系。结果:VPI组患者软腭长度、adequateratio小于健康对照组,PPW点在咽三角的位置相对于正常组偏上(P<0.05);翼颅基点和第一颈椎位置在2组间并无差异(P>0.05)。结论:腭裂术后VPI患者在成年期表现出软腭长度过短,ratio值<1.0,整个咽三角相对于正常组微呈逆时针偏转,PPW点位置上移的形态特征。提示:腭裂修复应选择重建软腭功能长度、保留正常腭咽结构的个体化治疗方法。更多还原

【Abstract】 Objective:To study the relationship between velopharyngeal morphology and velopharyngeal function in adults with velopharyngeal incompetence(VPI) after surgical treatment of cleft palate. Methods: Experimental group included 23 patients with VPI (10 male, 13 female, range from 16 to 36 years, mean age 18.3 years ).Control group included 20 normal adults (9 male,11 female, range trom 16 to 24 years,mean age 18.6 years). Skeletal landmarks and measurements were derived from tracing of lateral cephalograms. The measurements included velar length, pharyngeal depth, pharyngeal height and the ratio of velar length to pharyngeal depth. Additionally,the cranial base, cervical vertebrae, posterior nasal spine and the position of the posterior pharyngeal wall(PPW) in the pharyngeal triangle were analyzed. All data were subjected to the Student’s t test. Results:The patients with VPI had normal pharyngeal depth and a significantly shorter velar length(P< 0.05), resulting in a smaller length/depth ratio than that in the controls. The position of PPW in the pharyngeal triangle was located significantly superiorly in the VPI group than that in control group(P<0.05). Measurements of the anteroposterior and the vertical dimensions in the regions of cranial base, cervical vertebrae revealed no differences between the two groups(P>0.05). Conclusions:The velopharyngeal morphology of adults with VPI after surgical treatment of cleft palate is characterized by a shorter palate, smaller ratio of velar length to pharyngeal depth, slightly counterclockwise-rotated pharyngeal triangle and superiorly positioned PPW.更多还原