Oro-nasal fistula development and velopharyngeal insufficiency following primary cleft palate surgery - an audit of 148 children born between 1985 and 1997
Oro-nasal fistula development and velopharyngeal insufficiency following primary cleft palate surgery - an audit of 148 children born between 1985 and 1997
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DOI：
10.1016/j.bjps.2005.05.019
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发表时间：
2005-12-01
期刊：
影响因子：
--
通讯作者：
Reid, CA
中科院分区：
文献类型：
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作者：
Inman, DS;Thomas, P;Reid, CA
我们对我们单位的初次腭裂手术进行了审计，包括两种重要的术后并发症的发生率。多学科审计诊所从 1998 年 3 月到 2002 年 4 月进行了跟踪调查。在我们单位接受过初次腭裂手术的当地患有尖端或腭裂的患者。对一百四十八名患者进行了研究。随访时患者年龄范围为 3 岁 10 个月至 17 岁 4 个月。两名外科医生进行了初步手术。进行了 128 例 Wardill-Kilner 修复和 20 例 Von Langenbeck 修复。我们发现需要手术闭合的口鼻瘘发生率为 4.7%，需要随后进行咽部成形术的腭咽闭合不全 (VPI) 发生率为 26.4%。我们注意到，所涉及的唇裂类型影响 VPI 发生率，单侧尖端和腭裂患者的 VPI 为 16%，而孤立性腭裂患者的 VPI 为 29.2%，需要二次手术。手术结果由后续诊所的“言语裂隙审核方案”(CAPS) 言语治疗评估决定。在接受评估的所有患者中，只有 14.9% 表现出任何程度的鼻过度症状。我们的结果与其他最近的研究相比较，包括临床标准咨询小组 (CSAG) 关于唇裂和腭裂儿童治疗的报告。 (c) 2005 年英国整形外科医生协会。由 Elsevier Ltd 出版。保留 Alt 权利。
We present an audit of primary cleft palate surgery in our unit including rates of two important post-operative complications. Multidisciplinary audit clinics ran from March 1998 to April 2002 to follow up all. local patients with a cleft tip or palate who had undergone primary palatal surgery in our unit. One hundred and forty eight patients were studied. Patient ages at follow-up ranged from 3 years and 10 months to 17 years and 4 months. Two surgeons performed the primary surgery. One hundred and twenty eight Wardill-Kilner and 20 Von Langenbeck repairs were performed.We found a 4.7% rate of oro-nasal fistula development requiring surgical closure, and a 26.4% rate of velopharyngeal insufficiency (VPI) requiring subsequent pharyngoplasty. We noted that the type of cleft involved affected the rate of VPI, 16% of patients with unilateral cleft tip and palate versus 29.2% of patients with a solitary cleft palate requiring secondary surgery. Outcome of surgery was determined by a 'Cleft Audit Protocol for Speech' (CAPS) speech therapy assessment at follow-up clinics. Only 14.9% of all patients assessed demonstrated any degree of hypernasality.Our results compare favourably with other recent studies including the Clinical Standards Advisory Group (CSAG) report into treatment of children with cleft tip and palate. (c) 2005 The British Association of Plastic Surgeons. Published by Elsevier Ltd. Alt rights reserved.