软腭部反向双Z瓣腭裂修复术的解剖学基础及临床应用  

Applied anatomy of soft palate double reversing Z-plasty in repairing cleft palate and its clinical significance

作　　者：邓细河[1] 翟佳羽[1] 姜杰[1] 裴霞[1] 崔颖秋[1] 黎凡[1] 徐达传[2] 

机构地区：[1]广州市儿童医院口腔科,广东广州510120 [2]第一军医大学临床解剖学研究所,广东广州510515

出　　处：《中国临床解剖学杂志》2002年第3期230-232,共3页Chinese Journal of Clinical Anatomy

基　　金：广东省科委基金资助项目(99032)

摘　　要：目的:报道软腭部反向双Z瓣腭裂修复术的解剖学基础及其临床应用。方法:正常婴儿新鲜头颈标本5例、婴儿单侧完全性腭裂新鲜标本2例、婴儿双侧完全性腭裂标本1例。采用大体解剖和显微解剖,主要观察腭帆提肌和腭升动脉的走向。在2例新鲜腭裂标本的软腭区摹拟该术式进行解剖。结果:腭帆提肌至翼钩的距离为（4.5±1.6）mm,此处肌宽为（8.0±1.8）mm。软腭部Z瓣的角度取60°～70°,臂切口长度根据裂隙大小取中轴长的1/2或2/3。临床手术35例,有11例术后来院复查。经语音耳测评定,优良率达90.8％。结论:软腭部反向双Z瓣腭裂修复术式设计合理,操作得当,不会损伤腭帆提肌、血管主干和神经。能有效地重建腭部肌肉的解剖结构,延长和后退软腭,又可避免直线疤痕。Objective: To research the anatomic base and clinical significance of the soft palate double reversing Z - plasty in repairing cleft palate. Methods: The locations and directions of levator veli palatini muscle and ascending palatine artery were observed anatomically and microanatomyically on 5 fresh cephalocervical specimens, 2 unilateral cleft palate specimens and 1 bilateral cleft palate specimen. The operation of the soft palate double reversing Z - plasty were performed on 2 cases of cleft palate specimen. Results: The distance between levator veli palatini muscle and pterygoid hamulus was 4.5 ± 1.6 mm and the width of the muscle was 8.0 ± 1.8 mm. The specimen of cleft palate showed that the location and direction of levator veli palatini muscle and ascending palatine artery were the same as that of the normal group. The angle of the soft palate double reversing Z - Flap was 60°- 70°and the length of incision base on patient's flaw usually was half or two thirds of the flap axis. Thirty - five cases of operation have been performed, and 11 cases were reviewed after operation. The fine rate was 90.8 percent. Conclusions: The device of the soft palate double reversing Z - plasty is reasonable. This kind of operation should not damage the levator veli palatini muscle and can reconstruct effectively the anatomic structure of palatine muscle, elongate and retract the soft palate, and avoid straight scar.

关 键 词：腭裂 软腭部反向双Z瓣 解剖学 

分 类 号：R322.41[医药卫生—人体解剖和组织胚胎学] R618[医药卫生—基础医学]