West China Journal of Stomatology ›› 2020, Vol. 38 ›› Issue (1): 48-53.doi: 10.7518/hxkq.2020.01.009

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Changes of postoperative velopharyngeal function in children with cleft palate under 5 years old

Yin Heng,Huang Hanyao,Guo Chunli,Wang Xi,Shi Bing,Li Jingtao()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2019-01-17 Revised:2019-10-22 Online:2020-02-01 Published:2020-02-06
  • Contact: Jingtao Li E-mail:lijingtao86@163.com
  • Supported by:
    Clinical New Technology Project of West China Hospital of Stomatology, Sichuan University(LCXJS2017-9)

Abstract:

Objective To demonstrate the regularity of velopharyngeal function recovery after primary cleft palatoplasty and its correlation with different surgical procedures, ages, cleft types, and follow-up times. Methods Patients with cleft palate under 5 years old who had more than two follow-up records were included in this study, and consecutive evaluations of postoperative velopharyngeal function were performed. Univariate and multivariate logistic regression analysis were used to reveal the regularity of postoperative velopharyngeal function and the possible influencing factors. Results A total of 165 patients were included. Inconsistent functions of the velopharyngeal closure were observed in 31 patients, of which velopharyngeal insufficiency (VPI) in the first follow-up converted to velopharyngeal competence (VPC) in the second follow-up, accounting for 18.79% of the total, and 134 patients had consistent velopharyngeal function. The patients in the group who had consistent velopharyngeal function were younger than those in the group who were inconsistent, and the differences between the two groups were statistically significant. The younger the operation age, the patient’s velopharyngeal function was more likely to stabilize at the first follow-up. At the time of the first follow-up in 15, 28, and 40 months, the probability that the patients had stable postoperative velopharyngeal function was 80%, 90%, and 95%, respectively. Conclusion The recovery of velopharyngeal function after surgery is a dynamic process. The velopharyngeal status of patients can be converted from VPI to VPC. Meanwhile, VPC cannot switch to VPI. The follow-up time is the most important factor affecting the consistency of the evaluation of velopharyngeal function. Choosing appropriate follow-up time is the key to obtain the stable evaluation of velopharyngeal function.

Key words: cleft palate, velopharyngeal function, multivariate logistic regression analysis

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