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论文摘要

黏膜下腭裂的形态分类与腭咽功能分析

Morphological classification and velopharyngeal function analysis of submucous cleft palate patients

作者:尹恒 郭春丽 石冰 李杨 李精韬

Author:Yin Heng, Guo Chunli, Shi Bing, Li Yang, Li Jingtao.

收稿日期:2016-03-05          年卷(期)页码:2016,34(5):488-488-492

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:黏膜下腭裂,腭咽闭合功能,Calnan三联征,

Key words:submucous cleft palate,velopharyngeal function,Calnan triad,

基金项目:

国家自然科学基金青年科学基金(81500829)

中文摘要

目的 通过观测黏膜下腭裂患者的多项指标,以了解黏膜下腭裂的解剖形态与腭咽功能,以期提高临床诊断和治疗的准确率。方法对2008—2014年就诊的276例黏膜下腭裂患者的资料进行回顾性研究,对其术前腭咽功能、腭部形态、是否伴发唇裂、就诊原因等因素进行分析,观察各指标与腭咽功能的相关关系。结果276例患者中,术前腭咽闭合完全(VPC)者96例(34.78%),腭咽闭合不全(VPI)者151例(54.71%),边缘性腭咽闭合不全(MVPI)者29例(10.51%)。单纯黏膜下腭裂者196例(71.01%),伴发唇裂者80例(28.99%),伴发唇裂者较单纯的黏膜下腭裂者有更高的术前VPC率。黏膜下腭裂有不同的形态,完全具备Calnan三联征者仅103例(37.32%)。结论不同类型黏膜下腭裂的构成比和腭咽闭合率不同,需综合考虑各个因素与腭咽功能间的可能关系,谨慎选择治疗方案。

英文摘要

Objective To enhance the accuracy in diagnosis and management of submucous cleft palate via a thorough analysis of its anatomical and functional details.Methods Two hundred seventy-six submucous cleft palate cases from 2008 to 2014 were retrospectively investigated. Subgroup analysis were performed on the basis of preoperative velopharyngeal function, palatal morphology, cleft lip concurrence, and patient motives for treatment.Results Among the included cases, 96 (34.78%) were presented as velopharyngeal competence (VPC), 151 (54.71%) as velopharyngeal insufficiency (VPI), and 29 (10.51%) as marginal VPI (MVPI). Eighty cases (28.99%) also demonstrated cleft lip deformity, and 196 cases (71.01%) were merely submucous cleft palate. Compared with patients with submucous cleft palate only, those with cleft lips exhibited higher rates of complete velopharyngeal closure. The pathological spectrum of submucous cleft palate varied significantly. Only 103 (37.32%) cases met all the three diagnostic criteria proposed by Calnan.ConclusionGiven that the velopharyngeal closure rate varies among the subgroups, the factors analyzed in this study should be considered in the personalized management of submucous cleft palate.

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