The effect of Hotz Plate on the Articulation of Cleft Palate Children

目的：探讨霍氏钢板对腭裂儿童关节发育的影响。设计：(1)采用超声记录和分析腭裂婴儿在吸吮和吞咽过程中有无霍茨板的舌部运动，并与正常婴儿进行比较。(2)对15例使用Hotz Plate的腭裂患儿进行了关节检查，并与91例未使用Hotz Plate的腭裂患儿进行了比较。结果。(1)腭裂患者吸吮时舌背向下运动明显大于正常人。这种倾向也见于腭裂伴霍氏板的病例。结果表明，即使是霍氏板型腭裂婴儿也不能进行有效的负压吸吮。(2)有Hotz Plate的儿童与无Hotz Plate的儿童的发音无显著差异。在得出霍茨钢板对异常关节的影响的结论之前，还需要更多的纵向数据。我们发现大多数使用硬树脂制成的Hotz板的儿童关节瘫痪，该板通常松散地附着在上颚上。钢板与上颚的适应性似乎是防止关节异常的重要因素。在使用粘膜瓣进行腭成形术之前，在佩戴Hotz腭的儿童中发现了瘘管。在腭成形术前，应在一定时间停止使用Hotz腭，以避免局部过度刺激。

Objective: The object of the present study was to clarify the effect of Hotz Plate on the articulation of cleft palate children.Design: (1) We record and analyzed the tongue movement of cleft palate infants with and without Hotz Plate during sucking and swallowing by means of ultrasonography, and compared the result with that of normal infants. (2) We also examined the articilation of 15 children with Hotz Plate and compared the result with that of 91 cleft palate children with no history of the use of Hotz Plate. Results. (1) The downward movement of dorsum of the tongue during sucking was greater in the cleft palate cases than in the normal. This tendency was also seen in the cleft palate cases with Hotz plate. The result would suggest that even with Hotz Plate cleft palate infants could not make effective negative pressure sucking. (2) The articulation of children with Hotz Plate was not significantly different from that of those without Hotz Plate. More longitudinal data must be needed before we reach a conclusion on the effect of Hotz Plate on abnormal articulation. We found palatalyzed articulation in most of children with Hotz Plate made of hard resin, which was often loosely attached to the palate. Fitness of the plate to the palate seemed a significant factor to prevent abnormal articulation. Fistula were found in the children who had worn Hotz Palate until patatoplasty using a mucosal flap. The use of Hotz Palate should be discontinued at a certain time before the palataplasty in order to avoid excessive local stimulation.