Does palatal muscle reconstruction affect the functional outcome of cleft palate surgery?
Does palatal muscle reconstruction affect the functional outcome of cleft palate surgery?
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DOI：
10.1097/01.prs.0000259185.29517.79
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发表时间：
2007-05-01
影响因子：
3.6
通讯作者：
Askar, Sherif
中科院分区：
文献类型：
--
作者：
Hassan, Mohamed E.;Askar, Sherif
背景：本研究旨在比较不带腭内腭裂的两层腭成形术（Wardill-Kilner V-Y 推回技术）与带腭内腭成形术的三层腭成形术（Kriens 技术）在咽鼓管术后功能结果和腭咽功能方面的差异。 方法：进行了一项前瞻性队列研究，纳入了 70 名非综合征性腭裂患者（除粘膜下型唇裂）超过 2 年。根据腭裂类型将他们分为两个主要组：A 组（Veau 11 级）包括 32 名患者，B 组（Veau 1 级）包括 38 名患者。每组均随机选择Wardill-Kilner腭成形术（两层修复，不带腭内成形术）与Kriens腭成形术（三层修复，带腭内成形术）患者。结果：两组三层腭成形术术后早期分泌性中耳炎消退的倾向更大，挤出索环管所需的时间更少，复发发生率更低。分泌性中耳炎。双层腭成形术组术后腭咽功能不全的发生率较高。三层腭成形术中腭瘘的发生率更高。结论：腭裂患者的腭肌重建在腭咽功能和咽鼓管功能方面具有更好的功能效果。虽然术后腭瘘的总体发生率在可接受的范围内，但腭肌重建亚组的瘘管发生率较高。未来的研究需要包括更多的患者。
Background: This study was designed to compare two-layer palatoplasty (Wardill-Kilner V-Y pushback technique) without intravelar veloplasty versus threelayer palatoplasty (Kriens technique) with intravelar veloplasty with regard to postoperative functional outcome of eustachian tube and velopharyngeal competence.Methods: A prospective cohort study was conducted enrolling 70 patients with nonsyndromic cleft palate (except submucous type of cleft) over a period of 2 years. They were divided into two main groups according to the type of cleft palate: group A (Veau class 11) included 32 patients and group B (Veau class I) included 38 patients. In each group, Wardill-Kilner palatoplasty (two-layer repair without intravelar veloplasty) versus Kriens palatoplasty (three-layer repair with intravelar veloplasty) was randomly selected for patients.Results: For the three-layer palatoplasty in both groups, there was a greater tendency for resolution of secretory otitis media in the early postoperative period, less time required for extrusion of the grommet tube, and a lower incidence of recurrent secretory otitis media. The incidence of postoperative velopharyngeal incompetence was greater with two-layer palatoplasty group. The incidence of palatal fistula was greater with three-layer palatoplasty.Conclusions: Palatal muscle reconstruction in cleft palate patients confers better functional results regarding velopharyngeal competence and eustachian tube function. Although the overall incidence of postoperative palatal fistula is within the accepted range, the incidence of fistula is higher in the palatal muscle reconstruction subgroup. Future studies are required that include a larger number of patients.