唇顎口蓋裂手術後の遠隔成績
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概要
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It is well known that the main objectives of cleft lip and cleft palate surgery are plastic repair late. When and how the surgery should be perfor. med on each patient the surgeon may confront is an imposing problem. The present study based on the data from the Department of Otolarngology, Okayama University Medical Schol was started to elucidate the prohlems mentioned above. Six hundred and fifty four cases of cleft lip and/ or cleft palate patients were operated on at our clinic among which 225 patients were checked for speech changes and for cosmetic appearances of repaired cleft lip. Results obtained are as follows: 1.Cleft lip repair seemed not to impair the de-velopment of the maxilla.2.Surgical intervention to the premaxilla to set it back is not suggested. 3.Plastic repair of the nose deformity associated ded at the initial lip repair.We prefer the major shaping of the nasal cartilage after the child is about twelve years of age or older. 4.Surgery of the cleft palate as early as 2 years of age or earlier may exert bad influence upon the development of the maxilla. 5.One adult case of unoperated cleft lip and palate showed no underdevelopment of the maxilla. 6.Speech evaluation of the patients who had syrgery at the age of 3 years or later was better than that of the patients whose time of the surgery was under 3 years of age. 7.Nasal escape was measured as a test for velo- pharyngeal closure.Generally speaking, nasal escape is an import antcausative factor of imperfect, poor speech, but in minor cases patients produce good or acceptable speech in spite of considerable nasal escape.
- 社団法人 日本耳鼻咽喉科学会の論文