目的

评价腭部肿瘤切除术后采用腭大动脉岛状黏骨膜瓣修复重建腭部洞穿性缺损对患者术后语音功能的影响。

方法

选择腭部肿瘤切除后的洞穿性缺损患者40 例为研究对象，根据修复的方式分成两组，修复重建组20 例，即在手术切除腭部肿物同期运用腭大动脉岛状黏骨膜瓣修复腭部洞穿性缺损；非修复重建组20 例，即腭部肿物术后的洞穿性缺损未行手术重建。 采用主观语音清晰度（SI）测试法评价患者术后SI，另选20 例正常人作为对照组，对所收集资料进行单因素方差分析。

结果

修复重建组、非修复重建组和正常对照组的SI 平均测定值分别为（95.5 ±1.82）%、（60.9 ± 4.57）%、（97.6 ± 1.19）%，单因素两两比较显示，非手术重建组SI 显著低于手术重建组和正常对照组（P＜0.01），而手术重建组和正常对照组间SI 差异无统计学意义（P＞0.05）。

结论

腭大动脉岛状黏骨膜瓣修复腭部洞穿性缺损能更好地保持患者发音时口鼻腔的封闭，在语音功能恢复方面具有明显的优势。

Objective

To evaluate the articulatory function after excision of palatal tumor and reconstruction with palatal artery island flap.

Methods

Fourty patients who had surgical palatal insight defect were investigated in this study. They were divided into two groups. One was the surgical rehabilitation group （twenty） in which the palatal defects were reconstructed with palatal artery island flap，the other was the non-surgical rehabilitation group （twenty） in which the palatal defects were not reconstructed. Speech intelligibility test was conducted to evaluate the postoperative articulatory function.Twenty normal people were also involved in our study as the control group.

Results

The speech intelligibility test showed that the mean Speech intelligibility （SI） score in surgical rehabilitation group，non-surgical rehabilitation group and control group were （95.5±1.82）%、（60.9±4.57）%、（97.6±1.19）%respectively. The SI scores of non-surgical rehabilitation group were significantly lower than those of surgical rehabilitation group and control group （P＜0.01）； but there was no significant difference between surgical rehabilitation group and control group（P＞0.05）.

Conclusion

Surgical reconstruction with palatal artery island flap can better restore the speech intelligibility for the patients who have palatal defect.