单边口唇裂的长期语音结果:对早期和延迟硬 palates 关闭的比较研究
V L van Roey1, L Hofman2, P A J van der Goes1
1Department of Plastic and Reconstructive Surgery, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam.
The Journal of craniofacial surgery
|September 23, 2025
概括
在单边口唇裂 (UCLP) 手术中,早期硬 palatal 关闭会导致更好的语音结果. 诸如"一阶段造术议定书" (OSPP) 和"奥斯陆议定书" (OP) 等协议显示出改善的结果,特别是在短期和中期.
科学领域:
- 面外科手术 面外科手术
- 语音病理学 语音病理学
- 儿科医疗保健服务 儿科医疗保健服务
背景情况:
- 对于裂唇和裂的手术方案的相对有效性,特别是长期的语音结果,尚未得到充分证实.
- 单侧裂口唇和 palatal (UCLP) 治疗需要仔细考虑手术时间,以获得最佳的结果.
研究的目的:
- 为了评估和比较不同手术方案治疗的UCLP患者在5,12和22年后的长期语言结果.
- 根据语音结果指导选择UCLP最佳外科手术方案.
主要方法:
- 对285名UCLP患者进行了四种手术方案的前性横截面研究:晚期延迟硬口腔闭合方案 (L-DHPCP),早期延迟硬口腔闭合方案 (E-DHPCP),单阶段口腔整形方案 (OSPP) 和奥斯陆协议 (OP).
- 使用ICHOM标准集评估的语音结果,包括百分比和音符正确 (PCC),耳鼻喉能力 (VPC),语境可理解度 (ICS) 和CLEFT问卷.
- 使用顺序逻辑回归进行统计比较.
主要成果:
- 在5年后,与L-DHPCP和E-DHPCP相比,OSPP表现出优异的语言结果.
- 在12年后,奥斯陆议定书 (OP) 显示出最有利的结果,协议之间的差异正在减少.
- 在22年后,在E-DHPCP和L-DHPCP之间没有观察到语言结果的显著差异,尽管一些患者有持续的语言错误.
结论:
- 早期硬 palates 闭塞协议 (OSPP,OP) 与更好的短期和中间语音结果有关UCLP患者.
- 在非综合征性UCLP患者中优先考虑早期关闭,可以预防持续的语言问题,并减少进一步干预的需要.
- 虽然差异随着时间的推移而减少,但早期关闭策略似乎对UCLP的语言发展有益.
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