利用擴約肌咽成形術矯治懸壅顎咽成形術所造成的帆咽閉鎖不全

Using Sphincter Pharyngoplasty to Treat Velopharyngeal Insufficiency after Uvulopalatopharyngoplasty (UPPP)

陳建志(Jiann-Jy Chen) ； 蘇萬福(Wan-Fu Su)

《安泰醫護雜誌》 14卷2期 (2008/08) Pp. 103-109

https://doi.org/10.7078/TSMHMNJN.200808.0103

摘要

懸壅顎咽成形術是目前最常用來矯治打鼾或週邊阻塞性睡眠呼吸中止症的方法之一，術後的併發症包括出血、呼吸道阻塞、鼻咽窄縮或傷口癒合不良；此外，有些病患在術後1週內進食飲水時逆流入鼻腔或言語時鼻音過重，但是，有些在半年後仍然無法自行代償，成為所謂的帆咽閉鎖不全。本院於2002年12月經歷－22歲男性病患，曾因長久打鼾而於他院接受懸壅顎咽成形手術（2001年8月），打鼾的症狀已經消失，可是進食飲水時逆流到鼻腔的症狀卻一直困擾著他，最後於本院接受擴約肌咽成形術。術後追蹤迄今逾2年，已無進食飲水時逆流至鼻腔的困擾，亦無再次造成打鼾。特提出報告，作為其他醫師處理該併發症時的參考。

關鍵字

約肌咽成形手術 ； 懸壅顎咽成形術 ； 帆咽閉鎖不全

並列摘要

Currently, uvulopalatopharyngoplasty (UPPP) is one of the methods to treat snoring or obstructive sleep apnea syndrome (OSAS). The post-surgical complications comprise hemorrhage, acute airway obstruction, nasopharyngeal stenosis, or poor wound healing; in addition, over-correction of UPPP will produce velopharyngeal regurgitation or hypernasality within 1 week. Although most patients will recover from this annoying symptom in 6 months, poor compensation will result in permanent velopharyngeal insufficiency. A 22-year-old male patient who sustained UPPP in August 2001 developed velopharyngeal regurgitation. Although snoring relieved, the resultant sequela brought him to us. In December 2002, sphincter pharyngoplasty was used to solve it without any subsequent sequela or recurrent snoring. He was followed for 2 years. The postoperative course was uneventful. Therefore, we advocate a sphincter pharyngoplasty as a salvage procedure for velopharyngeal insufficiency after UPPP.

並列關鍵字

sphincter pharyngoplasty ； uvulopalatopharyngoplasty UPPP ； velopharyngeal insufficiency