咽頭弁移植術を行った先天性鼻咽腔閉鎖不全症の1例

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It is generally said that the causes of velopharyngeal incompetence in the absence of overt cleft palate are paralysis of the levator veli palatini muscle, short soft palate, or deformity of the nasopharynx.<BR>We experienced a case of a 15-year-old girl with cleft palate-type speech caused by congenital velopharyngeal incompetence with unilateral palate muscle paresis and short soft palate.<BR>We inspected speech and velopharyngeal functions and precisely practised analysis of speech on auditory impression, observation of nasopharynx with fiberscope, measurements of soft palate and nasopharynx by cephalometric radiography, electromyographic evaluation of bilateral levator veli palatini muscles, biopsy of levator veli palatini muscle tissue, analysis expiration air from oral and nasal cavity during phonation by flow nasality graph, and accoustic analysis of speech sound by soundspectrograph.<BR>We performed a inferiorly based posterior pharyngeal flap operation in this case, and got a good result. Postoperative hypernasality was distinctly diminished and improvement of articulation was achieved.
社団法人日本口腔外科学会の論文