Research for the process of attainning the velopharyngeal function after palatal repair -comparison between three types of the surgery-

1)腭裂术前状态评估：术前通过口腔内发现、侧位头像及咽外侧壁运动超声图评估腭裂状态。我们可以通过软腭的肌肉状况来评价腭咽功能* iVPF *j，通过软腭的功能来评价咽侧壁的运动。孤立性腭裂与唇腭裂的VPF差异不明显。2)腭裂修复后VPF的获得过程。采用Widmaier方法*F对35例患者术后VPF进行口内显像、鼻咽纤维镜、超声心动图评价。术后2年（3岁）达到元音发音功能。而辅音发音和吹音功能则在5岁左右达到。其功能不仅与软腭功能有关，还与外侧壁运动有关。B Furlow方法*F我们采用a中相同的方法对20例腭裂、8例黏膜下腭裂、3例唇腭裂患者的VPF进行了评估，术后2年（约3岁）几乎所有功能都恢复了功能。并与术后腭咽区消纳有关。应用Furlow法对初次修复后腭咽功能不全的患者进行了二次腭修复。术后16例患者，术后2 ~ 3个月软腭及咽外侧壁活动度增加。绝大多数病例术后6个月功能恢复正常。c推回法*F由于病例较少且伴有智力低下或其他与言语问题相关的异常，故无法对术后功能进行评估。3)演讲评价；在4-6岁时对患儿的语言能力进行评估。在Widmaier腭修复的病例中，在4-5岁时恢复正常语言，而在Furlow腭修复的病例中，在3-4岁时恢复正常语言。少

1) Assessment of preoperative condition of cleft palate : preoperative condition of cleft palate was assessed by intrraoral finding, lateral cephaligram and Echogram of the movement of lateral pharuyugeal wall. We can ralate the velopharyngeal function * iVPF *j with the musclar condition of the soft palate, and the movement of lateral pharyngeal wall with the function of the soft palate. We cannont find the difference of VPF between the isolated cleft palate and the clefi lip and palate.2) The process of the attainning of VPF after palate rrepair. A Widmaier method *F Assessment of the VPF after operation with 35 patients was done by intra oral finding, videofluorography, nasopharyngel fiber scope, and echogram. The function was attained at the vowel pronunciation in the 2 years after operation (3 years old). Whereas the function at the consonant pronunciation and blowing was attained about 5 years old. And the function was related to not only the function of the soft palate, but also … More the lateral wall movement.B Furlow's method *F We assessed the VPF of the patients (20 cleft palate, 8 submucous cleft palate, 3 cleft lip and palate) by the same method in A.The function was attained in the 2years after operation (about 3 years old) at almost all the functions. and it was related to the nallowing of velopharyngeal area after operation.Secondary plaratal repair by Furlow's method has been done in the patients with velopharyngeal insufficiency after primary repair. In 16 cases after operation, we find the increasing of the mobility of the soft palate and lateral pharyngeal wall in 2-3 montths after operation. And in almost all cases, normal function was attained after 6 months.C push back method *F We cannot assessed the function after operation because the case was few and they are complicated with mental retardation or other anomalies related to the speech problem.3) Assessment of the speech ; Speech results were assessed about the patients at the 4-6 years old. In the cases after Widmaier palatal repair, normal speech was attained at 4-5years old, however in the cases after Furlow's platal repair normal speech was attained 3-4 years old. Less