Objective: To explore the prognostic factors affecting the primary surgical management of aged patients with cleft palate.
Methods: This study reviewed aged patients with cleft palate who received Furlow palatoplasty (surgical age≥5 years) at the cleft center at West China Hospital of Stomatology from 2009 to 2014. The study retrieved intraoperative mea-surements, including velar length, pharyngeal depth, cleft width, maxillary width, cleft palate index, and palatopharyngeal ratio. Speech evaluation results at follow-up at least a year after surgery were also obtained. Logistic regression and retrospec-tive analyses were performed to identify correlative prognostic factors.
Results: One hundred and thirty-one patients were included (70 males and 61 females). Dichotomy logistic regression analysis revealed that pharyngeal depth was the only mea-surement considerably associated with postoperative velopharyngeal function. Pharyngeal depth deeper than 16 mm indicated high risk of postoperative velopharyngeal insufficiency.
Conclusions: Pharyn-geal depth is a significant prognostic factor for the primary surgical management of aged patients with cleft palate. Pharyn-goplasty might be considered when planning the primary management of aged patients.
目的 探究大龄腭裂患者一期腭裂整复术后腭咽闭合功能的影响因素。方法 本研究回顾了2009—2014年间在四川大学华西口腔医院唇腭裂外科以Furlow术式行手术治疗的大龄腭裂患者（手术年龄≥5岁），收集其软腭长度、咽腔深度、腭裂宽度、上颌宽度、腭裂指数和腭咽比6项指标的术中测量数据以及术后至少1年的语音复诊结果，进行logistic回归分析。结果 共纳入患者131人，其中男性70人，女性61人。logistic回归分析发现患者咽腔深度同术后腭咽功能强相关，咽腔深度越大，术后腭咽闭合不全风险升高。咽腔深度大于16 mm的患者术后腭咽闭合功能显著性降低，其他测量指标同术后腭咽功能无明显关联性。结论 大龄腭裂患者咽腔深度是其术后腭咽功能的敏感预测指标。对于咽腔深度大于16 mm的患者，可考虑一期手术时同步实施腭咽联合手术，以创造更好的腭咽闭合条件。.
Keywords: aged patient; cleft palate; logistic regression; velopharyngeal insufficiency.