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：通过口内发现、侧位头影测量和咽侧壁运动回声图评价腭裂术前状态。我们可以将腭咽闭合功能*iVPF*j与软腭的肌肉状况相关联，并将咽侧壁的运动与软腭的功能相关联。单纯腭裂与唇腭裂的VPF无明显差异。2)腭裂修复后VPF的获得过程。采用Widmaier方法对35例患者术后VPF进行评估，包括口内发现、电视透视、鼻咽凝胶纤维镜和超声检查。术后2年(3岁)达到元音发音功能。而辅音发音和吹音的功能是在5岁左右达到的。这种功能不仅与软腭的功能有关，而且与…有关A组采用相同的方法对20例(腭裂20例，粘膜下裂8例，唇腭裂3例)患者的VPF进行了评估，术后2年(约3岁)基本达到所有功能。对一期修复后的腭咽闭合不全患者，采用Furlow法进行二期修复。术后16例，术后2~3个月软腭部及咽侧壁活动度增加。6个月后功能恢复正常。C推背法*F因病例少，且伴有智力低下或其他与言语问题有关的异常，不能进行术后功能评定。3)言语评定：对4~6岁儿童的言语成绩进行评定。Widmaier腭裂修复术后4~5岁语音恢复正常，Furlow腭裂修复术后3~4岁语音恢复正常。较少

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