Oral velopharyngeal cerclage for cleft palate repair

Stomatological pharyngeal cerclage and cleft palate repair for the repair of cleft palate. Treatment of diseases: pharyngeal insufficiency Indication 1. Pharyngeal cerclage is an auxiliary surgery in cleft palate repair, which is suitable for simultaneous cleft palate repair. 2. It is especially suitable for patients with excessive pharyngeal cavity, postoperative soft palate, short uvula, congenital soft palate, shortness and occlusion. 3. It is also suitable for young children, so the method is simple and traumatic. Contraindications In addition to the general contraindications in cleft palate repair, there is no obvious contraindication for cerclage. Preoperative preparation 1. Prepare before surgery with conventional cleft palate repair. 2. Prepare arterial crochet and 7-0 suture for intraoperative use. Surgical procedure 1. Cut the edge of the slit and loosen the incision according to the conventional double pedicle method. Peel the mucoperiosteal flap. However, the posterior region of the loose incision molar is not widely separated, and the diaphragm is not cut. Without cutting the wing hooks, only the nasal mucosa is widely separated. 2. The pharyngeal circumcision 1 was made to make the pharyngeal side and the posterior pharyngeal wall tunnel: 0.5 cm was cut longitudinally at the midline mucosa of the posterior pharyngeal wall of the soft palate, and peeled off from the posterior part of the bilateral incision with a stripper, along the pharyngeal side The level of the annular fiber of the wall of the pharyngeal muscle (Pap sputum) is separated from the pharyngeal and pharyngeal wall to the pharyngeal side and the posterior pharyngeal wall. Wearing the cerclage line: the arterial crochet that has worn the 7-0 suture is removed from the right side of the incision, and then the incision is made along the pharyngeal side and the posterior wall tunnel to the posterior pharyngeal wall. The suture is withdrawn and the crochet is withdrawn. The thread of the posterior wall incision is re-threaded, so that the arterial crochet needle is inserted from the incision of the posterior pharyngeal wall into the posterior part of the left incision incision, and the needle is withdrawn. The free thread of the left side of the loose incision is inserted into the general suture needle, and the needle is inserted from the left side of the incision into the needle, along the anterior portion of the soft palate, about the decidua until the left fissure is worn out, and then the fissure is created from the right side. When the needle is inserted into the posterior part of the right side of the loose incision, the cerclage line is looped in the tissue. 3. Stitching the fissure wound edge and ligating the cerclage line The small incision of the posterior pharyngeal wall was sutured with 1-0 stitches with 1-0 stitches. The nasal mucosa, muscle and oral mucosa and soft palate mucosa were sutured in layers by 1-0 suture. Finally, the cerclage line is lifted, and the pharyngeal cavity is tightened to reach the pharyngeal wall at the posterior edge of the soft palate, knotted, and the bilateral loose incision is filled with iodoform gauze strips. complication 1. Postoperative wound oozing. 2. The suture of the hard palate area is tight, and the complex fissure forms a snout. 3. The entangled line is not well buried, and sometimes the wound surface can be exposed. After the wound edge is healed, the ligature is removed. 4. Early postoperative patients have a snoring sound while sleeping.