Hogan法治疗大龄腭咽闭合不全患者的临床疗效分析  

Clinical efficacy of Hogan posterior pharyngeal flap in repairing velopharyngeal insufficiency secondary to cleft palate in older patients

作　　者：董哲 谢莹 杨解纲 傅豫川[1] 李健[1] Dong Zhe;Xie Ying;Yang Jiegang;Fu Yuchuan;Li Jian(The State Key Laboratory Breeding Base of Basic Science of Stomatology(Hubei-MOST)&Key Laboratory of Oral Biomedicine Ministry of Education,Dept.of Oral and Maxillofacial Surgery,School and Hospital of Stomatology,Wuhan University,Wuhan 430079,China)

机构地区：[1]口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室、武汉大学口腔医学院口腔颌面外科,武汉430079

出　　处：《华西口腔医学杂志》2023年第6期713-718,共6页West China Journal of Stomatology

摘　　要：目的探讨使用Hogan法咽后壁组织瓣转移术治疗大龄腭咽闭合不全(VPI)患者的临床疗效。方法收集33例腭裂术后VPI患者,年龄10~35岁,平均年龄20.4岁。所有患者均行Hogan法咽后壁组织瓣转移术治疗腭咽闭合不全。采用汉语语音清晰度测定法评估患者语音情况,鼻咽纤维镜(NPF)评估腭咽闭合程度,并进行分级。平均随访时间13.3个月。结果33例患者术后创口均达到Ⅰ期愈合。术后语音清晰度明显提高,鼻漏气及高鼻音减少,与术前相比差异有统计学意义(P<0.05)。NPF检查示,术后腭咽闭合功能明显改善,30例(91%)患者腭咽闭合率达到Ⅰ级,3例(9%)患者达到Ⅱ级。结论Hogan法咽后壁组织瓣转移术可显著改善大龄VPI患者的腭咽闭合状况,减少鼻漏气和高鼻音。Objective The clinical effects and surgical procedures of Hogan posterior pharyngeal flap in the treatment of the older patients with velopharyngeal insufficiency(VPI)after cleft palate repair were investigated.Methods A total of 33 patients(aged 10-35 years;average of 20.4 years)with VPI secondary to cleft palate were included.They underwent Hogan posterior pharyngeal flap to improve velopharyngeal closure function.The clinical efficacy of the ope-ration was evaluated with Chinese speech clarity measurement and nasopharyngeal fiberscope(NPF),and the velopharyngeal closure was graded.The average follow-up time was 13.3 months.Results The wounds of all patients were healed by first intention,and speech assessment showed that the consonant articulation increased and the rate of hypernasality and nasal emission decreased significantly(P<0.05).NPF examination showed that the postoperative velopharyngeal closure function significantly improved,30 cases(91%)were gradeⅠ,and 3 cases(9%)were gradeⅡ.Conclusion Hogan posterior pharyngeal flap for VPI secondary to cleft palate can significantly improve velopharyngeal closure.

关 键 词：腭咽闭合不全 Hogan法咽后壁组织瓣转移术 语音清晰度 大龄患者 鼻咽纤维镜 

分 类 号：R782.22[医药卫生—口腔医学]