The Modified Langenbeck’s Technique Combined With Sphincter Pharyngoplasty Repair Of Cleft Palate Patients Over Seven Years Old

In recent years, more and more scholars begin to pay close attention to the treatmentof older patients with cleft palate, but for older patients with cleft palate for the type ofoperation mode, so as to improve the postoperative effect is still controversial. Somescholars claim issue first palatal reconstructive surgery, second line according to thecondition of patients to decide whether pharyngoplasty; Another part of the palatalpharyngoplasty scholars advocated over the same period. The same period with thedevelopment of oral medical technology, palatine pharyngoplasty combined surgerygradually obtained the affirmation, but what palatoplasty joint pharyngoplasty surgery, thepostoperative effect how? At present, the study of this part is lack of more objectiveevaluation. Improved orchid type method (Von Langenbeck method) palatoplasty andpalatine pharyngeal muscle flap pharyngoplasty more popular nowadays is two kinds ofoperation, the postoperative effects were also get the affirmation.Methods: A choice in our department’s33cases of cleft palate patients older thansyndrome as the research object,13cases, male and female patients, between the ages of7~30years, mean age20.7years. Preoperative line Nasopharyngeal fiber endoscopy (Nasopharyngeal Fiberoscope NPF) inspection, speech and nasal resonance evaluation.Are performed in the cannula under general anesthesia, mainly is divided into two steps:first palatine pharyngeal muscle flap repair pharyngoplasty, followed by improved orchidtype method of cleft palate reduction surgery, postoperative do conventional anti-infectiontreatment. In the follow-up of the patients were observed after half a year, a year, evaluatethe postoperative palatine pharyngeal closure function and speech intelligibility.Results: All the patients were postoperative for clinical stage I heal,14patients getpalatine pharyngeal closed completely (velopharynegeal competence VPC), four patientsbelong to marginality palatine pharyngeal closed, another15patients although belongs to thepalatine pharyngeal dysraphism (Velophargngeal Incompetence VPI) but palatine pharyngealdysraphism rate (rate of velopharyngeal Incompetence RVPI) were obviously improved, allpatients postoperative speech intelligibility are improved to varying degrees. None of thepatients with postoperative symptoms of temporary difficulty breathing during sleep.Conclusion:1. The older cleft palate patients do improved orchid type palatoplasty and palatinepharyngeal muscle flap pharyngoplasty, with surgical trauma small, short operative time,postoperative recovery time fast, the effect is more reliable and stable operation, easy tomaster, the popularization of the joint operation can be used as older patients with cleftpalate routine operation method of a kind of choice.2. Although in some cases still exist after velopharyngeal incompetence, but thevelopharyngeal rate has been improved to some extent, for the treatment of postoperativevoice to create certain conditions.Moreover palatine pharyngeal muscle flappharyngoplasty not destroy palatine pharyngeal organization structure, keep the motornerve function after stable effect, if the effect is not good again still can do otherpharyngoplasty treatment.3. Palatine pharyngeal muscle mucosal flap reconstruction palatine pharyngeal holeto ensure the postoperative patients good ventilation function, caused no sleep temporarydifficulty breathing symptoms. Postoperative respiratory complications associated withlow incidence is relative to the posterior wall disc pharyngoplasty another big advantage.