Abstract：
To introduce the modified pharyngeal flap of bilateral muscular rings (BMR), and to discuss the clinical effect of this operation in the correction of moderate and severe velopharyngeal insufficiency. The clinical data of 18 patients who underwent BMR surgery in the Department of Craniofacial Plastic and Aesthetic Surgery, School of Stomatology, The Fourth Military Medical University from May 2019 to July 2021 were retrospectively analyzed. There were 10 males and 8 females, with a median age of 8.5 years (aged from 5 to 34 years). The patients were diagnosed preoperatively with moderate to severe velopharyngeal insufficiency (velopharyngeal closure ratio<0.7). The results of nasopharyngoscopy and speech assessment were compared and analyzed before operation and at the follow-up 6 months after the operation to evaluate the changes in velopharyngeal function and speech. Eighteen patients underwent BMR, 4 patients had snoring (the symptom disappeared after a few weeks in 3 cases), and 2 patients had local erosion of the wound, which delayed healing. Postoperative nasopharyngoscopy showed that all patients achieved comparatively complete velopharyngeal closure, some patients got enhanced lateral pharyngeal wall motility, and all patients got active motility of posterior pharyngeal wall flap. The postoperative speech assessment was significantly improved compared with that before the operation. The preoperative median score was 9 (range 7-12), and the postoperative median score was 2 (range 0-4). The statistical analysis was performed by paired non-parametric Wilcoxon signed rank test, and the difference was statistically significant (P<0.001). BMR is a reliable method for the treatment of moderate and severe velopharyngeal insufficiency. This technique can achieve functional contraction of the full circumference of the ventilator while preserving the obstructive effect of the posterior pharyngeal wall flap, which is helpful to balance nasal ventilation and velopharyngeal closure and improve the velopharyngeal function of patients.
本文介绍了改良的双肌肉环咽后壁瓣术（BMR），并探讨该术式矫治中、重度腭咽闭合不全的临床效果并总结治疗经验。回顾2019年5月至2021年7月第四军医大学口腔医院颅颌面整形与美容外科接受BMR术的18例患者资料，其中男性10例，女性8例，年龄中位数为8.5岁（范围5~34岁），术前临床诊断为中、重度腭咽闭合不全（腭咽闭合率<0.7）。对比分析术前及术后半年随访时鼻咽镜检查及语音评估结果，评价患者腭咽功能及语音变化。结果显示，18例患者接受BMR术，4例打鼾（3例数周后症状消失），2例伤口局部糜烂，延期愈合。全部患者术后鼻咽镜检查腭咽闭合优良，10例患者咽侧壁运动加强，全部患者咽后壁瓣可主动运动。患者术前语音评分为9分（7~12分），术后语音评分为2分（0~4分），配对非参数Wilcoxon符号秩检验显示，术后语音评分显著低于术前（P<0.05）。BMR术可作为治疗中、重度腭咽闭合不全的可靠手段。该技术在保留咽后壁瓣阻塞作用的同时实现通气孔全周长功能性收缩，有助于平衡鼻通气与腭咽闭合，并改善患者腭咽功能。.
本文介绍了改良的双肌肉环咽后壁瓣术（BMR），并探讨该术式矫治中、重度腭咽闭合不全的临床效果并总结治疗经验。回顾2019年5月至2021年7月第四军医大学口腔医院颅颌面整形与美容外科接受BMR术的18例患者资料，其中男性10例，女性8例，年龄中位数为8.5岁（范围5~34岁），术前临床诊断为中、重度腭咽闭合不全（腭咽闭合率<0.7）。对比分析术前及术后半年随访时鼻咽镜检查及语音评估结果，评价患者腭咽功能及语音变化。结果显示，18例患者接受BMR术，4例打鼾（3例数周后症状消失），2例伤口局部糜烂，延期愈合。全部患者术后鼻咽镜检查腭咽闭合优良，10例患者咽侧壁运动加强，全部患者咽后壁瓣可主动运动。患者术前语音评分为9分（7~12分），术后语音评分为2分（0~4分），配对非参数Wilcoxon符号秩检验显示，术后语音评分显著低于术前（P<0.05）。BMR术可作为治疗中、重度腭咽闭合不全的可靠手段。该技术在保留咽后壁瓣阻塞作用的同时实现通气孔全周长功能性收缩，有助于平衡鼻通气与腭咽闭合，并改善患者腭咽功能。.
摘要：
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