颊脂肪垫在腭裂修复中的新用途  

A new application of buccal fat pad in cleft palate repair

作　　者：石伦刚[1] 唐世杰[1] 谢思田[1] 彭立红[1] 

机构地区：[1]汕头大学医学院第二附属医院整形外科,广东汕头515041

出　　处：《中国美容整形外科杂志》2016年第8期458-460,共3页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：汕头市医疗重点科技计划项目(汕府科2014242)

摘　　要：目的探讨将颊脂肪垫填塞于腭骨横板后方的空腔修复腭裂的效果。方法选取汕头大学医学院第二附属医院整形外科自2012—2013年入院的150例9～36个月（Ⅱ°、Ⅲ°）腭裂患儿作为研究对象。腭裂修复采用两瓣法联合腭帆提肌重建术。其中75例腭帆提肌后推后，采用双侧颊脂肪垫通过松弛切开填塞于软硬腭交接处的腭骨横板后方遗留的空腔设为实验组；75例不采用颊脂肪垫填塞于腭骨横板后方遗留空腔者设为对照组。随访时间定为术后1、3、6、12个月。观察两组中软硬腭交界处腭瘘的发生率，软腭瘢痕挛缩情况，软腭的长度及其运动度，术后语音效果。结果实验组无一例发生腭瘘，软腭瘢痕挛缩低于对照组，软腭长度及其运动度，语音效果明显优于对照组。结论颊脂肪垫填塞于腭骨横板后方空腔能够明显降低软硬腭交界处腭瘘的发生率，抑制软腭部的瘢痕挛缩，维持软腭的长度，增加软腭的运动度，从而改善发音，达到腭裂修复的较理想效果。Objective To explore the effect of the buccal fat pad packed in the air containing space, located in the back of the palatine bone rung during the cleft palate repair. Methods From September 2012 to Septem- ber 2013, 150 patients aged 9 to 36 months with Ⅱ°to Ⅲ°cleft palate were divided into two groups, the experimental group （ n = 75） and the control group （ n = 75）. The Bardach two flap palatoplasty and Sommerlad levator muscle of palatine velum reconstruction cleft palate repair methods were used. The experimental group was repaired by pack- ing the buccal fat pad into the air containing space located in the back of the palatine bone rung. The control group was without packing of the buccal fat pad. The two groups were both followed up at 1, 3, 6 and 12months after operation. The occurrence rate of cleft palate fistula, scar contracture, length and movement of soft palate, and speech quality were measured and compared between the two groups. Results There was no cleft palate fistula occurrence in the experimental group. There was lower scar contracture of the soft palate in the experimental group than that in the control group. The length and movement of the soft palate and the speech quality were better in the experimental group than those in the control group. Conclusion Application of the buccal fat pad packed in the air containing space located in the back of the palatine bone rung in cleft palate repair will reduce the occurrence rate of cleft palate fistula, inhibit scar contracture, maintain the length and augment the movement of the soft palate, thereby improving the speech quality of patients. The desired effect of cleft palate repair can be obtained.

关 键 词：腭裂修复 颊脂肪垫 腭骨横板后方 填塞 

分 类 号：R782.2[医药卫生—口腔医学]