口蓋裂の二次手術としての咽頭弁形成術

一色法

抄録

The three important parts of Isshiki's pharyngeal flap operation are:
1) elevating of a superiorly based flap from the posterior pharyngeal wall, 2) folding it over to keep the mucosal surface outside, and 3) suturing the raw surfaces denuded on the folded ridge of the flap and on the nasal side of the soft palate.
The first advantage of this method is that the velopharynx becomes narrowed during articulatory closure. The second is that postoperative scar contraction is avoided because there is very little raw surface and the flap is sufficiently thick. The only disadvantage is the feeling of nasal obstruction feeling in some and snoring in most cases.
Isshiki's folded pharyngeal flap was used in 29 patients, who were then observed for at least one year.
Complete closure of the velopharynx was achieved in 23 (79%), normal articulation was possible after articulation training. The other six patients were severely deformed before surgery or in the older age group, and their improvement was less satisfactory.
We conclude that this operative technique is a fairly good procedure for velopharyngeal dysfunction.