Sommerlad腭帆提肌重建术修复腭裂后腭咽结构特征的分析  

Analysis of velopharyngeal morphology in operated cleft palate patients with levator veli palatini retropositioning according to Sommerlad

作　　者：鲁勇[1] 石冰[2] 王志勇[1] 徐明耀[1] 

机构地区：[1]南京大学医学院附属口腔医院口腔颌面外科,南京210008 [2]口腔疾病研究国家重点实验室华西口腔医院唇腭裂外科(四川大学),成都610041

出　　处：《华西口腔医学杂志》2013年第5期472-475,共4页West China Journal of Stomatology

基　　金：江苏省卫生厅医学科研基金资助项目(H201239);南京市医学科技发展基金资助项目(QRX1125)

摘　　要：目的分析Sommerlad腭帆提肌重建术后腭咽闭合完全患者生长发育期腭咽结构特征与腭咽功能之间的关系。方法对18例Sommerlad腭帆提肌重建术修复不完全性腭裂术后腭咽闭合完全患者（T1组）、14例Langenbeck法修复不完全性腭裂术后腭咽闭合不全患者（T2组）及正常人13例（对照组）进行鼻咽纤维镜检测和X线头颅侧位片分析，比较3组间腭咽闭合度、软腭长度、咽腔深度、Adequateratio（软腭长度／口因腔深度）的差异，分析软腭与咽后壁接触点PPW在腭咽三角的位置关系。结果T1组18例患者腭咽闭合完全；T2组有7例患者腭咽闭合度达到70％，5例为50％～70％，2例在50％以下。T1组软腭长度、Adequateratio与对照组无明显差异（P〉O．05），腭咽结构图与对照组相似。T2组软腭长度和Adequateratio分别为（22．9±2．3）mm、0．95±0．14，均小于T1组[（25．7±2．3）mm、1．43±0．26]及对照组[（29．9±2．7）mm、1．45±0．26]，其差异有统计学意义（P〈0．05）；PPW点在腭咽三角的位置相对于对照组偏上。结论Sommerlad腭帆提肌重建术后腭咽闭合完全患者的腭咽结构与正常人相似；Langenbeck法修复术后腭咽闭合不全患者表现为咽腔过深，Adequateratio值小于1．0，整个腭咽三角呈逆时针偏转上移的特征。Objective To study the relationship between velopharyngeal morphology and velopharyngeal function in operated cleft palate patients with velopharyngeal competence （VPC） with levator veli palatini retropositioning according to Sommerlad. Methods Three groups were included in the study. The experimental group comprised 18 incomplete cleft patients （group T1） repaired with VPC repaired with levator veli palatini retropositioning according to Sommerlad and 14 incomplete cleft patients （group T2） with velopharyngeal incompetence （VPI） repaired with Langenbeck＇s technique. The control group was composed of 13 normal adults. The outcome of the velopharyngeal function by nasopharyngoscopy and lateral cephalogram was assessed. Skeletal landmarks and measurements were derived from the tracing of lateral cephalo- grams. The measurements included velar length, pharyngeal depth, and adequate ratio of velar length to pharyngeal depth. The cranial base, cervical vertebrae, posterior nasal spine, and the position of the posterior pharyngeal wall （PPW） in the pharyngeal triangle were also analyzed. All data were subjected to student＇s t-test of statistical significance. Results All 18 subjects in group T1 obtained complete velopharyngeal closure. Velopharyngeal closure in seven, five, and two subjects in group T2 was 70%, 50% to 70%, and less than 50%, res- pectively, according to the results of nasopharyngoscopy. The lateral velar length （25.7 mm±2.3 mm） in group T1 was similar to that of the control group （29.9 mm±2.7 mm） （P〉0.05）. The pharyngeal depth in group T1 was shorter than that in the other two groups, and the adequate ratio （1.43±0.26） was similar to that in the normal group （1.45±0.26）. Group T2 had a significantly short velar length （22.9 mm±2.3 mm） and normal pharyngeal depth, resulting in a small length/depth ratio （0.95±0.14） than that in group T1 and the control group. PPW in the pharyngeal triangle was positioned superiorly in group T2 compared with the

关 键 词：腭裂 腭咽闭合 腭咽形态 头影测量 

分 类 号：R782.22[医药卫生—口腔医学]