目的比较兰氏和双反Z法腭裂修复术后患儿的语音清晰度,寻找重建腭咽闭合的最佳手术方法。方法选取2009年至2013年在我院口腔颌面外科就诊的先天性软腭裂患儿69例,其中行双反Z法腭裂修复术35例(双反Z法组),行兰氏法腭裂修复术34例(兰氏法组)。患儿3.5岁后随访,由3名语音师进行单盲性审听,比较两组患儿术后语音清晰度。结果语音测评结果显示,双反Z法组患儿术后患者语音清晰度平均达到88.72%±6.05%,明显高于兰氏法组的71.31%±3.46%,语音改善明显。结论双反Z法能够充分缩小咽腔、延长软腭,重建软腭肌肉结构,更有利于恢复良好的腭咽闭合功能。

Objective To explore a best surgical method for the correction of velopharyngeal closure by comparing the speech intelligibility between von Langenbeck palatoplasty and double-opposing Z-plasty in children with cleft palate. Methods From 2009 to 2013, 69 cases with cleft soft palate were selected. Thirty-five cases were repaired using double-opposing Z-plasty (double-opposing Z-plasty group), others were repaired using von Langenbeck palatoplasty (von Langen-beck group).All cases were followed up after the age of 3.5 years.A single blind hearing was conducted by 3 phonetics,and the speech intelligibility between the two groups was compared. Results The speech assessment showed that the average speech intelligibility was 88.72%±6.05% in double-opposing Z-plasty group, which was significantly higher than that in von Langenbeck group 71.31%±3.46%. Conclusion Double-opposing Z-plasty repair can decrease the pharyngeal cavity and increase the length of soft palate to reconstruct the soft palate muscle,which is beneficial for the correction of velopharyngeal closure.