CAJ | 학술논문

目的探讨腭裂术后腭前瘘的防治措施.方法对于23例完全性腭裂伴牙槽嵴裂患者,采用两瓣后退术式时,两侧黏骨膜瓣尽量前移,封闭硬腭前端腔隙,于软硬腭交界处切开,交界处创面以颊肌黏膜瓣覆盖,延长软腭,观察术后腭前瘘发生率及腭咽闭合情况.结果 23例患者,采用以上术式,术后1个月复查,无一例腭前瘘并发症出现,10例术后1年鼻咽镜检查腭咽闭合90%～100%,6例随访6个月,腭咽闭合80%～85%.结论在一期手术中采取措施避免腭前瘘的发生或尽量缩小瘘口,减少二期手术几率或降低难度,减轻患者痛苦,不失为一种较好的预防措施.
목적 탐토악렬술후악전루적방치조시.방법 대우23례완전성악렬반아조척렬환자,채용량판후퇴술식시,량측점골막판진량전이,봉폐경악전단강극,우연경악교계처절개,교계처창면이협기점막판복개,연장연악,관찰술후악전루발생솔급악인폐합정황.결과 23례환자,채용이상술식,술후1개월복사,무일례악전루병발증출현,10례술후1년비인경검사악인폐합90%～100%,6례수방6개월,악인폐합80%～85%.결론 재일기수술중채취조시피면악전루적발생혹진량축소루구,감소이기수술궤솔혹강저난도,감경환자통고,불실위일충교호적예방조시.
Objective To discuss the preventive measures of anterior palatal fistula by modified the operation of cleft palate. Methods For 23 patients of complete cleft palate with alveolar ridge cleft, bilateral mucoperiosteum flap was moved forward as possible so as to close fistula front of hard palate, and incised junction of the hard and soft palate to prolong soft palate and the wound was repaired by buccal mucosal flap.The incidence of anterior palatal fistula and velopharyngeal closure after operation was observed. Results Twenty-three patients were rechecked 1 month after operation ,there was no anterior palatal fistula occurring,10 cases were examined by epipharyngoscope 1 year after operation,the velopharyngeal closure was 90%-100%. Six cases were followed up for 6 months,the velopharyngeal closure was 80%-85%. Conclusions For second-stage operation methods of anterior palatal fistula, there are too many discussions of selection criterias, advantages and disadvantages. If first-stage operation is taken measures to prevent anterior palatal fistula or decrease the diameter of fistula as possible. It reduces percentage of second-stage operation or decreases the difficulty. It should get more attention in the clinical works.