A Study Of Cleft Palatet Repair By Reconstruction Of The Levator Veli Palatini Muscle And The Tensor Veli Palatini Muscle Unde The Operating Microscope

Objective:Cleft palate repair has been hundreds of years of history,all the surgeons were in goals of palatal repair to Complete close the cleft palate,patients can get normal pronunciation after surgery,and do not affect the growth of the maxillary.The purpose of this study is To explore a functional palatoplasty resulting in velopharyngeal competence,to minimize any detrimental effects on maxillofacial growth and easy to learn new methods of cleft palate repair.Methods:In this study,velopharyngeal function criteria:lvelopharygeal competence:clear pronunciation,language ability better diagnosis velopharyngeal competence,pronunciation is not clear but gills drums not leak and nasopharyngeal fiberscope examination can be foud soft palate separate the nasal cavity from the oropharynx also diagnosis velopharygeal competence.2 velopharyngeal insufficiency:pronunciation is not clear and nasopharyngeal fiberscope examination can be foud Soft palate can not separate the nasal cavity from the oropharynx diagnosis palate velopharyngeal insufficiency.This study is divided into four methods to study the soft palate muscle reconstruction.Method 1:This group is performed under the operating microscope.Dislocation of the tensor veli palatini muscle and the levator veli palatini muscle have been dissected by revisiting anatomy of musculature of soft palate.71 cases of cleft palate were repaired with this method,and the results of their articulation,the velopharyngeal function and the complications after operation were observed.And linberg operation in 30 cases,two flaps in 30 cases of contrast.Method2:This group is performed under the operating microscope.Dislocation of the tensor veli palatini muscle and the levator veli palatini muscle have been dissected by revisiting anatomy of musculature of soft palate.31 cases of velopharyngeal insufficiency were corrected with this method,and the results of their articulation and the velopharyngeal function after operation were observed,And Furlow palatoplasty in 15 cases corrects velopharyngeal insufficiency,posterior pharyngea flap pharyngoplasty in 15 cases corrects velopharyngeal insufficiency Of contrast.Method3:170 cases of congenital cleft palate reconstructive have been used the technique of velar muscles are only dissected from the oral mucosa of the velum,and then cut off the muscle and the nasal mucosa at the posterior edge of the hard palate retropositioning of the velar musculature.Method4:This group is performed under the endoscope.20 cases of cleft palate have been repaired which performed under the endoscope.Dislocation of the tensor veli palatini muscle and the levator veli palatini muscle have been dissected by revisiting anatomy of musculature of soft palate.In this study All Patients were followed every 6 months at least three years,To Clear the soft palate muscle reconstruction for repair of cleft palate velopharyngeal function recovery advantage.Results:Methodsl Results:Muscle Dissection and Retroposition under the operating microscope group,the proportion of patients with velopharyngeal competence was 91.55%(65/71),linberg operation group The proportion of patients with velopharyngeal competence was 70%(21/30),two flaps group the proportion of patients with velopharyngeal competence was 53.33%(16/30).Muscle dissection and retroposition under the operating microscope group reconstruction of congenital cleft palate velopharyngeal function significantly better than the other two methods(P<0.05).Methods2 Results:Muscle dissection and retroposition under the operating microscope corrected velopharyngeal insufficiency group.The proportion of patients with velopharyngeal competence is 93.55%(29/31)percent,Furlow palatoplasty in 15 cases corrects velopharyngeal insufficiency,The proportion of patients with velopharyngeal competence is 86.67%(13/15),posterior pharyngea flap pharyngoplasty group proportion of patients with velopharyngeal competence is 40%(6/15).Muscle dissection and retroposition under the operating microscope corrected velopharyngeal insufficiency group and Furlow palatoplasty corrected velopharyngeal insufficiency group was no difference(P>0.05),Muscle dissection and retroposition under the operating microscope corrected velopharyngeal insufficiency group and posterior pharyngea flap pharyngoplasty group have significant difference(P<0.01).Methods3 Results:The proportion of patients with velopharyngeal velopharyngeal competence is 91.18%(155/170),The overall fistula requiring repair in these 170 palate repairs is 8 cases.Methods4 Results:The proportion of patients with velopharyngeal competence is 85%percent(17/20).Conclusion(s):Cleft palate is performed under the operating microscope or under the endoscope.Dislocation of the tensor veli palatini muscle and the levator veli palatini muscle have been dissected by revisiting anatomy of musculature of soft palate.The abnormal musculature returned to normal physiological position,The proportion of patients with velopharyngeal competence more than 85%,It is worth promoting in further clinical application.especially the technique of velar muscles are only dissected from the oral mucosa of the velum,and then cut off the muscle and the nasal mucosa at the posterior edge of the hard palate is a reliable,simple,easy,time saving technique that has yielded excellent surgical and speech outcomes.the technique is accordance with Chinese condition expected to become a common method for cleft palate repair.