Objective Velopharyngeal insufficiency (VPI) is a common postoperative sequela secondary tocleft palate.It could significantly impairpatients'living quality.Treatment of VPI includes surgery and speech therapy,but the reported success rates are inconsistent.A consensus in the literatures is needed,to guide procedure selection for patients with VPI.Methods This is a retrospective study on management options for patients with VPI.This study systematically introduces the assessment,management plan and treatment effect of VPI,in the Craniofacial center of Hospital Stomatology of Xi'an Jiaotong University.The challenges of VPI diagnosis and treatment with cleft palate are discussed in-depth.Results Most patients with VPI underwent evaluation and treatment (surgical or/and speech therapy) had speech improvement.The average value of hypernasality decreased from 3.67 before interventions to 1.57 after interventions.A multidisciplinary team using multi-modal to evaluate velopharyngeal function and speech.All patients had no bleeding,would dehiscence or fistula postoperatively.The difficulty of stimulability test was significantly reduced.Fourteen patients completed speech therapy,with the averaged treatments period of 3 months.Conclusions Speech pathologist is the manager of speech rehabilitation of cleft palate patients with VPI.The operation skill plays a key role in the treatment of VPI.Detailed diagnostic information is important for performing excellent surgical techniques.The cooperation of surgeon and speech pathologist,could be helpful to achieve the final speech rehabilitation.%目的 探讨腭裂术后腭咽闭合不全的有效治疗方案.方法 回顾性分析2016年1月至2017年1月在西安交通大学口腔医院唇腭裂治疗中心治疗的腭裂术后腭咽闭合不全30例患者的资料,男19例,女11例,年龄4～25岁,系统地介绍了腭裂术后腭咽闭合不全治疗、管理方案.用术后并发症、腭咽功能变化、诱发测试难易程度、构音治疗周期(次数)作为整个治疗方案是否有效果、效率的评价指标.结果 所有患者术后均无出血、裂开、瘘孔发生,2例患者术后第2周仍存在打鼾症状;术后过高鼻音较术前均有下降,平均值从3.67降至1.57,2例出现低鼻音;诱发测试难易程度明显减低,13例患者使用1种提示即可诱发正确发音;14例患者完成了言语语言治疗,平均治疗周期为3个月.结论 外科医生与言语语言病理医生的合作,能够实现腭裂术后腭咽闭合不全功能性康复并实现最终言语康复.
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