咽頭弁移植術

DOI
  • 坂下 英明
    明海大学歯学部病態診断治療学講座口腔顎顔面外科学第2分野
  • 重松 久夫
    明海大学歯学部病態診断治療学講座口腔顎顔面外科学第2分野

書誌事項

タイトル別名
  • The pharyngeal flap operation

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説明

  Velopharyngeal incompetence (VPI) is a major cause of dysphonia. VPI after an operation of cleft palate has been treated with various methods, such as use of speech aid prostheses or palatal lift prostheses, retropharyngeal augmentation, repushback surgery, pharyngoplasty by muscle transplantation, the pharyngeal flap operation, and a combination of repushback surgery and the pharyngeal flap operation. Among others, in recent years the pharyngeal flap operation seems to have become the most popular secondary surgical technique for VPI. We report on the method of unified velopharyngeal plasty combined with the repushback method for patients who suffer from significant VPI after cleft palate surgery. In this report, we describe the technique in detail. <br>  A midline split of the soft palate is performed. In the pharyngeal flap operation, it is necessary to gain exposure of the posterior pharyngeal wall. In order to push back the palatal flap sufficiently, we bend the bilateral hamular if necessary, and perform Z-plasty on the nasal mucous membrane of the soft palate. The nasal mucosa is then supplemented with a pharyngeal flap. The flap is elevated from the posterior pharyngeal wall as a superiorly based flap. Two small rings (pharyngeal poruses) of φ 5-6 mm are made by connecting the levator veli palatini and the superior constrictor pharyngeus muscle. Consequently, the soft palate is attached to the posterior pharyngeal wall with a wide base. <br>  We consider that unified velopharyngeal plasty combined with the repushback method is one of the most suitable techniques for patients with significant VPI, since it results in minimal shrinkage and scar contracture of the flap.

収録刊行物

  • 小児口腔外科

    小児口腔外科 20 (2), 154-160, 2010

    日本小児口腔外科学会

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