上颌骨Le Fort Ⅰ型截骨前徙术对唇腭裂患者腭咽结构及功能影响的临床探讨  

Clinical study of the effect on the velopharyngeal structure and function of maxillary hypoplasia patients of cleft lip and palate after Le Fort Ⅰ osteotomy for maxillary advancement

作　　者：郭秀娟[1] 耿海霞[1] 郑海英 魏明勇[1] 

机构地区：[1]济宁医学院附属医院口腔科,山东济宁272000

出　　处：《临床口腔医学杂志》2017年第11期664-667,共4页Journal of Clinical Stomatology

基　　金：山东省医药卫生科技发展计划项目(2013WSO343)

摘　　要：目的:探讨上颌骨Le Fort Ⅰ型截骨前徙术对唇腭裂患者腭咽结构及功能的影响。方法:选择2010~2016年行上颌Le Fort Ⅰ型截骨前徙术的上颌发育不足唇腭裂患者15例,男9例,女6例,平均年龄21.41岁。所有患者在术前、术后1月拍摄头颅定位侧位片及发"i"音位头颅定位侧位片,对腭咽部结构进行测量分析。同时采用喉动态频闪喉镜录像录音检查、吹气实验及语音清晰度测听比较手术前后腭咽闭合功能的变化。结果:上颌骨最大前移幅度为6 mm,最小为3 mm,平均前移(4.28±2.02)mm,术后咽腔深度明显增大(P<0.05),同时软腭长度及软硬腭夹角较术前明显增大(P<0.05),软腭厚度减小。结论:上颌骨Le Fort Ⅰ型截骨前徙术造成患者咽腔深度显著增加,对腭咽闭合功能可能有一定的不良影响;但术后腭咽部软组织代偿性改变会在一定程度上减轻腭咽闭合不全。Objective：To study the effect on the velopharyngeal function of maxillary hypoplasia patients of cleft lip and palate after Le FortⅠ osteotomy for maxillary advancement. Methods：Fifteen patients with maxillary hypoplasia of cleft lip and palate underwent Le FortⅠ osteotomy. Cephalometric analysis was obtained from all patients at centric occlusion and during phonating. The larynx dynamic strobolaryngoscope video recording check, the test of blowing and the evaluation of speech were carried out to compare the changes of velopharyngeal function before and after operation. Results：The average maxillary advancement was （4.28 ±2.02） mm. The depth of pharyngeal cavity increased significantly after operation（P〈0.05）. The length of the soft palate and the angle between soft and hard palate increased obviously than preoperative （P〈0.05 ） . And the thickness of the soft palate were reduced. Conclusion：Correction of maxillary hypoplasia by using Le FortⅠosteotomy for maxillary advancement will increase the velopharyngeal cavity depth,which may impair velopharyngeal competence. But the compensatory effects of velopharyngeal soft tissue may alleviate this impairment to some extent.

关 键 词：上颌Le FORT Ⅰ型截骨前徙术 唇腭裂 上颌发育不足 腭咽功能 

分 类 号：R782.2[医药卫生—口腔医学]