The Use of Nasendoscopy in Assessing Velopharyngeal Function in Case Received Pharyngeal Flap

William N.Williams;Maria Ines Pegoraro-Krook;Paul W.Wharton;Patrick J.Antonelli

1:Craniofacial Center University of Florida Gainesville

2:Department of Speech Pathology and Audiology University of Sao Paulo Bauru

3:Interdisciplinary Center University of Florida Jacksonville

4:Department of Otollaryngology University of Florida Gainesville F

摘要
纤维鼻内窥镜可以在不干扰腭咽部活动的情况下,如实提供其在发音状态下的清晰图像。与侧位X线透视不同,借助鼻内窥镜,检查者能从腭咽口的上方检查腭帆与咽侧壁、咽后壁的互相接触部位,从而了解不同发音状态下腭咽口的整体情况,尤其是能观察侧位X线透视不能揭示的侧方裂隙的部位及大小,为治疗提供参考。因此,越来越多的言语病理学家与耳鼻喉科学家合作,将其应用于对腭咽功能的评估。本文对该项检查的适应症,操作要领及注意事项、报告书写等作了详细介绍,认为发口腔音时出现持续性过度鼻音及鼻漏气的患者均应接受鼻内窥镜检查,检查时镜体应自中鼻道插入,深度不能超过10 cm,检查中所用的言语测试材料应多样化,以便全面了解患者的腭咽功能。对于检查结果的描述,作者推荐了IWG建立的分级标准;文中还采用图解方式强凋了应用鼻内窥镜诊治腭咽关闭不全患者的价值(咽瓣成形后仍关闭不全者,软腭麻痹者,癌症术后腭咽部大面积缺损及不可修复的腭裂患者),指出鼻内窥镜检查不仅有助于了解腭咽口裂隙的部位,大小及构型,而且有助于指导设计、安装赝体。对于腭咽功能不全患者,应用鼻内窥镜评估其腭咽功能,同时结合口腔检查、感知评估及X线透视,必将有助于制定更为合理的治疗方案。
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作者
William N.Williams;Maria Ines Pegoraro-Krook;Paul W.Wharton;Patrick J.Antonelli
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