鼻咽旁黏膜肌肉瓣在宽大腭裂修复中的作用

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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.

Key words： cleft palate paranasopharyngeal musculomucosal flap palatal fistula velopharyngeal insufficiency

Received: 28 May 2023

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	ZHOU Jianhong
	REN Changqun
	LI Yong

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ZHOU Jianhong,REN Changqun,LI Yong. Role of paranasopharyngeal musculomucosal flap in repair of wide cleft palate[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(2): 98-101.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2024/V35/I2/98

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[12]	Rafael D, Lun-Jou Lo. Buccal fat pad interposition in modified small double-opposing Z-plasty palatoplasty using medial incision approach: a technical note [J]. J Plast Reconstr Aesthet Surg,2022, 75(10):3877-3903.
[7]	Brian C Sommerlad. A technique for cleft palate repair [J]. Plast Reconstr Surg, 2003, 112 (6): 1542-1548.
[8]	Subhendu K, Jerry R J, Ramesh K S. Outcome of nasal layer reinforcement with autologous dermis in cleft palate repair on postoperative fistula formation [J]. Cleft Palate Craniofac J, 2022. DOI:10.1002/jemt.23095.
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[14]	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.
[10]	Bumsted R M. A new method for achieving complete two-layer closure of a massive palatal cleft [J]. Arch Otolaryngol, 1982, 108(3):147-150.
[15]	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.
[11]	Kerry A M, Jenn P, Danielle R, et al. Anatomical study of domain rescue of palatal length in patients with a wide cleft palate: buccal flap reconstruction in primary palatoplasty [J]. Cleft Palate Craniofac J, 2024,61(1):103-109.
[16]	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.
[12]	Rafael D, Lun-Jou Lo. Buccal fat pad interposition in modified small double-opposing Z-plasty palatoplasty using medial incision approach: a technical note [J]. J Plast Reconstr Aesthet Surg,2022, 75(10):3877-3903.
[13]	Anton H Sc, Eric H, Michael R, et al. Role of free-tissue transfer in the treatment of recalcitrant palatal fistulae among patients with cleft palates [J]. Plast Reconstr Surg, 2004, 113(4):1131-1139.
[14]	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.
[15]	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.
[16]	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.