摘要目的 探讨鼻咽旁黏膜肌肉瓣在宽大腭裂修复术中对裂隙关闭的作用。方法 选取联勤保障部队第910医院于2005-06至2021-06收治的宽大腭裂患者138例,其中81例采用常规两瓣法行腭裂修复术,57例在两瓣法的基础上,通过广泛游离鼻咽旁黏膜肌肉瓣来辅助关闭鼻腔侧黏膜裂隙。术后统计患者腭瘘发生率、腭咽闭合不全发生率来比较两种术式的差异性。结果 采用鼻咽旁黏膜肌肉瓣来辅助关闭裂隙,患者术后腭瘘发生率及腭咽闭合不全发生率(5.26% vs. 29.82%)均低于常规两瓣法(16.05% vs. 48.15%),有统计学差异(P＜0.05)。结论 鼻咽旁黏膜肌肉瓣能显著减低患者术后腭瘘发生率及腭咽闭合不全发生率,在宽大腭裂的修复中具有重要意义。
Abstract：Objective To investigate the clinical efficacy of paranasopharyngeal musculomucosal flaps on cleft closure during the primary palatoplasty for patients with wide cleft palate.Methods A total of 138 cases with wide palatal clefts who underwent primary palatoplasty from June 2005 to June 2021 were retrospectively analyzed. Eighty-one cases underwent routine two-walve procedure, and auxiliary paranasopharyngeal musculomucosal flaps were applied to close the nasal mucosal gap through extensive mobillization plus two-walve procedure in another 57 cases. After operation, the incidence of palatal fistula formation and velopharyngeal insufficiency were assessed to compare the difference between the two surgical methods.Results The incidence of postoperative palatal fistula formation and velopharyngeal insufficiency in the group of two-walve procedure with the auxiliary paranasopharyngeal musculomucosal flap (5.26% vs. 29.82%) was lower than that in the group of two-walve procedure applied only (16.05% vs. 48.15%).Conclusions Paranasopharyngeal musculomucosal flap can significantly reduce the incidence of postoperative palatal fistula and velopharyngeal insufficiency in patients, which is of great significance in the repair of wide cleft palate.
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Piero C, Paolo A, Valerio R, et al. Cleft lip and palate: technical strategies for the primary palatoplasty [J]. J Craniofac Surg, 2008, 19(5):1343-1347.
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Clark J M, Saffold S H, Israel J M. Decellularized dermal grafting in cleft palate repair [J]. Arch Facial Plast Surg, 2003, 5(1):40-44.
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Hamidreza F, Seyed S H, Hojjat M. Quantitative and qualitative assessment of medial osteotomy of the greater palatine foramen in wide cleft palate repair [J]. World J Plast Surg, 2022, 11(2):129-134.
2024, Vol. 35 
