摘要
本文报告从88年以来应用双Z形瓣手术,修复62例腭裂。随访12例,多数满一年以上。语言优良率91.58％,其中正常率58.25％。认为双Z形瓣手术具有下列特点:(1)矫正了错位的腭提肌,既形成咽括约肌环,又长了软腭;(2)不需要硬腭的粘骨膜瓣后退,不在腭部做松驰切口没有马蹄形瘢痕形成。可能减少了对颌骨发育的影响;(3)腭部切口缝合后呈Z形,而不是直线,故不产生直线收缩。术后软腭形态近于常人,没有悬雍垂内陷现象;(4)口腔没有暴露创面,不需用碘纱填塞,减少了术后的组织水肿反应。所以术后病人的静脉输液及住院时间明显缩短。
The main problem in repairing cleft palate by the Von Langenbeck mehtod are velo pharyngeal insufficincy and maxillary hypoplasia.It has been proved that early stage cleft palate repair can increase the normal speech rate.However it is possible to interfere the maxillar development.Up to now, the discussions about the operation are continued.
Dr.Furlow reported double Z-plasty for repairing cleft palate in 1986.This method had creativeness both in theory and technique and made a important step in resolving the main problems at the same time.
We had operated on 62 cases of cleft palate by double Z-plasiy since 1988.12 cases of them were received follow-up study.Most of them exceede the time more than 1 year postoperatively.It had been showed that excellent and good speech rate was 91.58% and the normal speech rate was 58.25%.The advantage of double Z-plasty had been proved as following:
1.The deficient tensor veli palatini muscles and levator velipalatini muscles were replaced to normal situation.The velo pharyngeal orbicularis muscle was formed and the soft palate was prolonged.
2.The backward displacement of the mucoperiosteal flaps in hard palate was not required.Also, the lateral relaxing incisions were not needed.
Because there were not horseshoe scar, the interference to maxillar development may be reduced.
3.The straight contraction of the scar can be avoided in postoperation.The shape of soft palate can be changed postoperatively as the same as normal.
4.There were not open wounds.There-fore lodoform gauge packs were not needed.The tissue oedema was lightened postoperatively.The time of useing antibiotics by vien injection for the patients can be shortened.The scheduals of the patients staying in hospital can be reduced.
出处
《口腔颌面外科杂志》
CAS
1992年第1期16-20,共5页
Journal of Oral and Maxillofacial Surgery
