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中华口腔医学研究杂志(电子版) ›› 2024, Vol. 18 ›› Issue (01) : 5 -11. doi: 10.3877/cma.j.issn.1674-1366.2024.01.002

青年编委专栏

腭裂修复术的理论发展与技术改良:Sommerlad-Furlow改良腭裂整复技术
杜美君, 曾妮, 石冰, 黄汉尧()   
  1. 口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院唇腭裂外科,成都 610041
  • 收稿日期:2023-08-16 出版日期:2024-02-01
  • 通信作者: 黄汉尧

Theoretical development and technique modification in cleft palate repair: Sommerlad-Furlow modified palatoplasty

Meijun Du, Ni Zeng, Bing Shi, Hanyao Huang()   

  1. State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases and Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2023-08-16 Published:2024-02-01
  • Corresponding author: Hanyao Huang
  • Supported by:
    National Natural Science Foundation of China(82301148); Science and Technology Support Program of Sichuan Province(2022NSFSC0743, 2022NSFSC1519); Sichuan Postdoctoral Science Foundation(TB2022005); The Research and Development Program, West China Hospital of Stomatology, Sichuan University(RD-02-202107)
引用本文:

杜美君, 曾妮, 石冰, 黄汉尧. 腭裂修复术的理论发展与技术改良:Sommerlad-Furlow改良腭裂整复技术[J]. 中华口腔医学研究杂志(电子版), 2024, 18(01): 5-11.

Meijun Du, Ni Zeng, Bing Shi, Hanyao Huang. Theoretical development and technique modification in cleft palate repair: Sommerlad-Furlow modified palatoplasty[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2024, 18(01): 5-11.

腭裂是最常见的先天性颌面部畸形之一,通常会影响患者的生理和社会心理功能。腭裂修复的目标是重建患者腭部结构、恢复患者语音功能。本文旨在回顾腭裂手术治疗的历史发展进程,从腭裂修复的两大目标、现代腭裂修复的目标、腭裂修复新目标的实现方法及腭裂修复的未来发展等4个方面进行讨论。

Cleft palate is one of the most common congenital maxillofacial deformities, often affecting the physical and psychosocial function of patients. The goal of cleft palate repair is to reconstruct the palatal structure and restore speech function. This review aimed to demonstrate the historical development of cleft palate repair and discuss the following aspects: two major goals of cleft palate repair, the goals of modern cleft palate repair, the strategy to achieve new goals of cleft palate repair, and the future development of cleft palate repair.

图1 腭大神经血管束剥离器 黄点示腭大神经血管束位置,红色箭头示剥离器绕腭大神经血管束旋转方向。
图2 使用Sommerlad-Furlow改良腭裂整复技术(S-F技术)进行腭裂修复的手术过程示意图 A:切口设计的标记(虚线)略倾向于口腔侧,以在鼻腔侧保留更多的黏膜组织;B:分离并抬高口腔黏膜骨膜瓣(硬腭)和口腔黏膜瓣(软腭),松解大腭神经血管,在翼内板(白色箭头处的虚线)和鼻腔Z形瓣表面设计咽旁切口;C:做咽旁切口后,从翼内板向颅底(白色箭头处)剥离鼻腔黏骨膜瓣,然后从腭骨后缘向前方剥离,缝合硬腭鼻层,解剖左侧鼻腔侧肌肉腭帆提肌,然后在鼻腔层软腭上完成Z成形;D:完全关闭鼻腔层,包括插入和缝合Z字形黏膜瓣,以及将左侧解剖的腭帆提肌瓣缝合到右侧黏膜瓣表面;E:关闭口腔层。
[1]
McDowell FVistnes LM. The source book of plastic surgery [M]. Baltimore:The Williams & Wilkins Co.,1977.
[2]
Weinberger BW. An introduction to the history of dentistry in America(vol. Ⅱ)[M]. St Louis,MO:The CV Mosby Company,1949.
[3]
Robert MJC. Traité Des Principaux Objets De Médecine,Avec Un Sommaire De la plûpart des Thèses soutenues aux Ecoles de Paris,depuis 1752 jusqu′en 1764:On y a joint des Observations de pratique.1[M]. Paris:Lacombe,1766.
[4]
Jr MRalph D. Cleft Craft:The evolution of its surgery,vol 3:Alveolar and palatal deformities[M]. Boston:Brown and Company,1980:1211.
[5]
Dorrance GMShirazy E. The operative story of cleft palate[M]. Philadelphia:W.B. Saunders,1933.
[6]
Dorrance GM. Lengthening the soft palate in cleft palate operations[J]. Ann Surg192582(2):208-211. DOI:10.1097/00000658-192508000-00003.
[7]
Hynes W. Pharyngoplasty by muscle transplantation[J]. Br J Plast Surg19503(2):128-135. DOI:10.1016/s0007-1226(50)80020-6.
[8]
Kriens OB. Fundamental anatomic findings for an intravelar veloplasty[J]. Cleft Palate J19707:27-36.
[9]
Millard D. Cleft craft I:The unilateral deformity[M]. Boston,Toronto:Little,Brown and company,1976.
[10]
Sommerlad BC. The use of the operating microscope for cleft palate repair and pharyngoplasty[J]. Plastic Reconstr Surg2003112(6):1540-1541. DOI:10.1097/01.PRS.0000085598.26409.E3.
[11]
Furlow LT. Cleft palate repair by double opposing Z-plasty[J]. Plastic Reconstr Surg198678(6):724-738. DOI:10.1097/00006534-198678060-00002.
[12]
LaRossa DJackson OHKirschner RE,et al. The Children′s Hospital of Philadelphia modification of the Furlow double-opposing z-palatoplasty:Long-term speech and growth results [J]. Clin Plast Surg200431(2):243-249. DOI:10.1016/S0094-1298(03)00141-X.
[13]
Kirschner REWang PJawad AF,et al. Cleft-palate repair by modified Furlow double-opposing Z-plasty:The Children′s Hospital of Philadelphia experience[J]. Plast Reconstr Surg1999104(7):1998-2010. DOI:10.1097/00006534-199912000-00009.
[14]
Jackson OStransky CAJawad AF,et al. The Children′s Hospital of Philadelphia modification of the Furlow double-opposing Z-palatoplasty:30-year experience and long-term speech outcomes[J]. Plast Reconstr Surg2013132(3):613-622. DOI:10.1097/PRS.0b013e31829ad109.
[15]
Horswell BBCastiglione CLPoole AE,et al. The double-reversing Z-plasty in primary palatoplasty:Operative experience and early results[J]. J Oral Maxillofac Surg199351(2):145-149. DOI:10.1016/s0278-2391(10)80011-4.
[16]
Khosla RKMabry KCastiglione CL. Clinical outcomes of the Furlow Z-plasty for primary cleft palate repair[J]. Cleft Palate Craniofac J200845(5):501-510. DOI:10.1597/07-063.1.
[17]
Williams WNSeagle MBPegoraro-Krook MI,et al. Prospective clinical trial comparing outcome measures between Furlow and von Langenbeck Palatoplasties for UCLP[J]. Ann Plast Surg201166(2):154-163. DOI:10.1097/SAP.0b013e3181d60763.
[18]
Losee JEKirschner RE. Comprehensive cleft care[M]. New York:McGraw Hill Companies,2008.
[19]
Li YTao HYao M,et al. Intraoral scanning evaluation of maxillary arch changes post modified sommerlad palatoplasty for around three years[J]. Plast Reconstr Surg2023. DOI:10.1097/PRS.0000000000010799.
[20]
Wong LSLu TCHang DTD,et al. The impact of facial growth in unilateral cleft lip and palate treated with 2 different protocols [J]. Ann Plast Surg202084(5):541-544. DOI:10.1097/SAP.0000000000002232.
[21]
Ross RJohnston M. Facial growth in surgically repaired cleft lip and palate[M]//Ross RJohnston M. Cleft lip and palate. Baltimore:Williams and Wilkins Company,1972:158-201.
[22]
Friede HJohanson B. A follow-up study of cleft children treated with vomer flap as part of a three-stage soft tissue surgical procedure. Facial morphology and dental occlusion[J]. Scand J Plast Reconstr Surg197711(1):45-57. DOI:10.3109/02844317709025496.
[23]
Mølsted KPalmberg ADahl E,et al. Malocclusion in complete unilateral and bilateral cleft lip and palate. The results of a change in the surgical procedure[J]. Scand J Plast Reconstr Surg Hand Surg198721(1):81-85. DOI:10.3109/02844318709083584.
[24]
Koberg WKoblin I. Speech development and maxillary growth in relation to technique and timing of palatoplasty[J]. J Maxillofac Surg19731(1):44-50. DOI:10.1016/s0301-0503(73)80012-8.
[25]
Putri ILWidiono ESLiana S,et al. A systematic review:Early simultaneous vomer flap with primary cleft lip repair,does it bring more benefits?[J]. Cleft Palate Craniofac J2023:10556656231192295. DOI:10.1177/10556656231192295.
[26]
Chate RDibiase DBall J,et al. A comparison of the dental occlusions from a United Kingdom sample of complete unilateral cleft lip and palate patients with those from the Euro cleft Study [C]. The Transactions of The 8th International Congress on Cleft Palate and Related Craniofacial Anomalies,Singapore,1997.
[27]
吴敏,朱祉冰,石冰,等.华西Sommerlad-Furlow腭裂修复术后腭瘘率的研究[J].华西口腔医学杂志202038(2):166-169. DOI:10.7518/hxkq.2020.02.010.
[28]
Ross RB. Treatment variables affecting facial growth in complete unilateral cleft lip and palate[J]. Cleft Palate J198724(1):5-77.
[29]
Emami AHashemzadeh H. Does primary vomer flap significantly affect maxillary growth?[J]. World J Plast Surg20209(1):62-66. DOI:10.29252/wjps.9.1.62.
[30]
Ruiz-Rodriguez RLopez-Noriega JC. S222:Secondary management of cleft lip/cleft palate deformities in both soft and hard tissues[J]. J Oral Maxillofacial Surg200765(9):90. DOI:10.1016/j.joms.2007.06.149.
[31]
Karadede Ünal BDurmus Kocaaslan NKaradede B,et al. 3D evaluation of the effects of traumatic surgical techniques on Vomer bone volume and morphology in the treatment of lip and palate clefts[J]. Ulus Travma Acil Cerrahi Derg202228(2):187-195. DOI:10.14744/tjtes.2020.36880.
[32]
Liu YZhang SSakran KA,et al. Observation of palatal wound healing process following various degrees of mucoperiosteal and bone trauma in a young rat model[J]. Biology(Basel)202211(8):1142. DOI:10.3390/biology11081142.
[33]
Sommerlad BLosee JKirschner R. Cleft palate repair with minimal hard palate dissection and radical muscle reconstruction[M]//Losee JKirschner R. Comprehensive cleft care VolumeⅡ. 2nd ed. NewYork:Thieme Medical Publishers,Inc.,2016:962-975.
[34]
Huang HLi JLi C,et al. Sommerlad-Furlow modified palatoplasty:A retrospective study[J]. J Craniomaxillofac Surg202351(4):238-245. DOI:10.1016/j.jcms.2023.04.004.
[35]
Sakran KAWu MYin H,et al. Evaluation of postoperative outcomes in two cleft palate repair techniques without relaxing incisions[J]. Plast Reconstr Surg2023152(1):145-154. DOI:10.1097/PRS.0000000000010230.
[36]
Sakran KAWu MAlkebsi K,et al. The sommerlad-furlow modified palatoplasty technique:Postoperative complications and implicating factors[J]. Laryngoscope2023133(4):822-829. DOI:10.1002/lary.30385.
[37]
Sakran KAYin JYang R,et al. Early cleft palate repair by a modified technique without relaxing incisions[J]. Cleft Palate Craniofac J2022:10556656221135288. DOI:10.1177/10556656221135288.
[38]
Huang HShi B. Combined technique provides new choice for cleft palate repair[EB/OL].(2023-06-29)[2023-11-06].

URL    
[39]
Cheng XHuang HLuo X,et al. Wnt7a induces satellite cell expansion,myofiber hyperplasia and hypertrophy in rat craniofacial muscle[J]. Sci Rep20188(1):10613. DOI:10.1038/s41598-018-28917-6.
[40]
Cheng XSong LLan M,et al. Morphological and molecular comparisons between tibialis anterior muscle and levator veli palatini muscle:A preliminary study on their augmentation potential[J]. Exp Ther Med201815(1):247-253. DOI:10.3892/etm.2017.5391.
[41]
Li JHuang YLi J,et al. A novel rat model for muscle regeneration and fibrosis studies in surgical lip repair[J]. Cleft Palate Craniofac J2022:10556656221136171. DOI:10.1177/10556656221136171.
[42]
Cheng XShi BLi J. Distinct embryonic origin and injury response of resident stem cells in craniofacial muscles[J]. Front Physiol202112:690248. DOI:10.3389/fphys.2021.690248.
[43]
Cheng XHuang YLiu Y,et al. Head muscle fibro-adipogenic progenitors account for the tilted regeneration towards fibrosis [J]. Biochem Biophys Res Commun2022589:131-138. DOI:10.1016/j.bbrc.2021.12.009.
[44]
程旭,黄艺璇,李精韬,等.牙颌面肌肉发育和再生特征的研究进展[J].国际口腔医学杂志202148(1):71-76. DOI:10.7518/gjkq.2021014.
[45]
陈泽华,吴敏,刘颖蒙,等.腭裂伤口延迟愈合规律的初期研究[J/OL].中华口腔医学研究杂志(电子版)202317(1):45-48. DOI:10.3877/cma.j.issn.1674-1366.2023.01.006.
[46]
Su CLPai BCJWang SH,et al. Velopharyngeal function change after two-jaw orthognathic surgery in patients with cleft:A study on 162 consecutive cases[J]. Plast Reconstr Surg2023. DOI:10.1097/PRS.0000000000011003.
[47]
Gillgrass T. The orthodontic management of patients with cleft lip and palate:From birth to the late mixed dentition[J]. Br Dent J2023234(12):873-880. DOI:10.1038/s41415-023-5955-x.
[48]
Gillgrass T. The orthodontic management of patients with cleft lip and palate:From the permanent dentition and the adult returning to the service[J]. Br Dent J2023234(12):892-898. DOI:10.1038/s41415-023-5956-9.
[49]
Soares SRezende Pucciarelli MGHideki de Lima Toyoshima G,et al. Stereophotogrammetry to evaluate young adults with and without cleft lip and palate after orthodontic and restorative treatment[J]. J Prosthet Dent2022128(3):355-360. DOI:10.1016/j.prosdent.2020.10.025.
[50]
Naros ABartel SBacher M,et al. Speech development in cleft palate with and without robin sequence[J]. Plast Reconstr Surg2022149(2):443-452. DOI:10.1097/PRS.0000000000008730.
[51]
Ruiz-Guillén ASuso-Ribera CRomero-Maroto M,et al. Perception of quality of life by children and adolescents with cleft lip/palate after orthodontic and surgical treatment:Gender and age analysis[J]. Prog Orthod202122(1):10. DOI:10.1186/s40510-021-00354-8.
[52]
Huang HCheng XWang Y,et al. Analysis of velopharyngeal functions using computational fluid dynamics simulations[J]. Ann Otol Rhinol Laryngol2019128(8):742-748. DOI:10.1177/0003489419842217.
[53]
Xu YHuang HWu M,et al. Rapid additive manufacturing of a superlight obturator for large oronasal fistula in pediatric patient [J]. Laryngoscope2023133(6):1507-1512. DOI:10.1002/lary.30352.
[54]
Chen JYang RShi B,et al. Obturator manufacturing for oronasal fistula after cleft palate repair:A review from handicraft to the application of digital techniques[J]. J Funct Biomater202213(4):251. DOI:10.3390/jfb13040251.
[55]
Yin HLiu C. Effect of listeners′ language backgrounds on pure tone detection in temporally modulated noise[J]. JASA Express Lett20211(9):094402. DOI:10.1121/10.0006286.
[56]
Huang HZheng OWang D,et al. ChatGPT for shaping the future of dentistry:The potential of multi-modal large language model[J]. Int J Oral Sci202315(1):29. DOI:10.1038/s41368-023-00239-y.
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