咽頭弁基部 raw surface の被覆に遊離頬粘膜移植を応用した口蓋裂児の1例 A case of cleft palate in a child treated by free buccal mucosa grafting to cover the raw surface of the base of a pharyngeal flap
We report a case of cleft palate in a child whose speech was improved by covering the raw surface of the base of a pharyngeal flap with a free buccal mucosal graft.<BR>A 2-year-8-month-old girl with cleft palate was brought to our clinic because of speech disorders. She had undergone palatoplasty at 1 year of age, but the surgery resulted in wound dehiscence. Therefore, she underwent reoperation at 1 year 6 months. The scar on the palate was remarkable, and we observed a defect encompassing a wide area of the soft palate. There was no detectable movement of the soft palate during phonation. The distance from the edge of the palate to the posterior pharyngeal wall was lomm and remarkably wide.<BR>We planned superior-based pharyngeal flap surgery combined with re-pushback at 4 years 6 months of age, but the raw surface of the pharyngeal flap was too wide. It was impossible to cover this area with tissue from the soft palate or pharynx. Therefore, we grafted free buccal mucous membrane to this area to prevent scar contraction.<BR>Preoperatively, we recognized glottal explosive sounds in all consonants and severe hypernasality, but after 4 years she has acquired almost normal articulation.
日本口腔外科学会雑誌 51(3), 120-123, 2005-03-20
Japanese Society of Oral and Maxillofacial Surgeons