【摘要】 目的:探讨Furlow反向双Z法修复腭裂的疗效。方法:用Furlow反向双Z法修复腭裂86例,术前、后测量左、右裂隙旁切牙腭侧到软腭后缘曲线距离与直线距离;术后3、6个月随访,主观语音判听,6个月后鼻咽纤维镜检查,年龄小未能配合检查者,于3~4周岁后可配合时复诊检查。结果:本组31例左、右裂隙旁切牙腭侧到软腭后缘曲线、直线长度均显著延长(P<0.01),59例语言评估,所有语音清晰度,高鼻音以及鼻漏气得到明显改善,但连续发音时仍有错误,需进一步语言治疗。其中22例术后6个月后进行鼻咽纤维镜检查,腭咽闭合率大于0.7占77.3%,其中闭合率0.9~1.0占22.7%,效果佳。结论:Furlow反向双Z法腭裂修复术可有效封闭裂隙,取得良好的腭咽闭合功能,语言效果良好,值得推广。更多还原

【Abstract】 Objective:To discuss the efficacy of Furlow’s double-opposing Z-palatoplasty for cleft palate repair.Method:Eighty-six patients with cleft palate were operated with a combined Furlow and two-flap palatoplasty,the raw surface on the palate was closed by the Vomer flap,buccinator mucosal flap or pedicled buccal fat pad grin.Results:All the palates had satisfactory results without infection,difficulties in opening mouth and facial nerve injury.Thirty-one palates were measured for both a straight-line and a curved distance while the patient was under general anesthesia before and immediately after the palatoplasty.It demonstrated a significant elongation in palate(P<0.01).Fifty-nine patients were followed up and perceptual speech evaluation demonstrated significant better speech outcomes.Twenty-two patients were evaluated by nasoendoscopic assessment of velopharyngeal function in more than 6 months after operation.The coefficients(77.3%)was better than 0.7,which 22.7% of them was between 0.9 ~ 1.0.Conclusion:Two-flap and Furlow’s double-opposing Z-palatoplasty can get a satisfactory soft palate lengthening and speech outcomes.It can avoid bone surface exposing and scar formation.更多还原