目的探讨应用改良兰氏法早期修复单侧完全性腭裂的效果。方法选择18~24个月龄的单侧完全性唇腭裂患者65例,手术均采用改良兰氏法修复腭裂,切开裂隙边缘,在腭部黏膜距上牙龈缘1~2 mm处,自尖牙近中始向后切开至上颌结节后方,剥离腭侧黏骨膜瓣、鼻腔黏膜及犁骨瓣,松解腭前血管神经束,重建腭帆提肌,分层缝合关闭裂隙。结果手术后出现腭裂穿孔、复裂2例,近期语音恢复良好53例,远期语音恢复良好58例。结论用改良兰氏法早期修复腭裂,既能获得良好的语音效果,又能减少日后颌骨发育障碍,为术后功能的重建创造条件。
Objective To explore the effect of improved Langenbeck in the early treatment of unilateral complete cleft palate. Methods 65 patients with unilateral complete cleft palate,aged 18-24 months,were selected and performed with improved Langenbeck to repair of cleft palate: after cutting the edge of the first fracture,in the palatal mucosa 1-2mm to the gingival margin,by incising from the canine teeth to the upper back near the jaw of nodules,peel palatal mucoperiosteal flap,nasal mucosa and plow flap were isolated, palatine neurovascular bundle were released,levator palatine velum were reconstructed,and layered suture were closed layer by layer. Results Perforation and rima were observed in 2 cases. 53 cases received early fine sounding recovery and 58 received long term fine sounding recovery. Conclusion Modified Langenbeck can achieve fine sounding effect,reduce barriers to the future development of jaw,and lay foundation for the functional reconstruction after surgery.