边缘性腭咽闭合不全临床诊断方法的初步探索及可靠性分析

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[中图分类号] R782.2+2 （20 [文献标志码] A [doi] 10.7518/hxkq.2025.2024425

[Abstract]ObjectiveA stable，reliable，and easily implementable clinical diagnostic method for marginal velopharyngeal insuficiency（MVPI） was establishedonthe basisofthe subjective hearing judgementofhypernasality and objective examinationofvelopharyngealclosuretoaddressthelackofunifieddiagnosticcriteria forMVPI.MethodsNasopharyngeal fiberscopy and speech assessment results were collcted from postoperative patients with cleft palate. Theseresults wereusedtoanalyze thediffrences inthe distributionofnasalresonance inpatients with differentvelopharyngeal closure ratiosandthecorrelation between velopharyngeal closure ratios and nasalresonance status.Mild-to-mod

eratehypernasalitywithitscorrespondingelopharyngeal closure ratio was employed to establish the diagnostic criteriaofMVPI.The reproducibilityofthecriteriaand whether the patients with MVPI diagnosed by using the criteriaexhibited significantlydifferent speechcharacteristics compared with other patients were verified.Re

sultsA strong correlation was found between velopharyngeal closure ratios and nasal resonance （P<0.001 ）.Mild-tomoderate hypernasalitymainly corresponded to velopharyngeal closure ratios ranging from 90% to 99% ，and the combinationof the two characteristics as the diagnostic criteria forMVPI demonstrated good consistency （Kappavalue ：=0.789 P<0.001 ）.Moreover，under the diagnostic criteria，significant differences in nasal resonance （P<0.001 ），nasal emission （P=0.007） ，and misarticulation （P<0.001 ）were found between patients with velopharyngeal insufficiency and those with MVPI.ConclusionCombining the subjective hearing judgement of mild-to-moderate hypernasalitywith velopharyngeal closure ratios over 90% undernasopharyngeal fiberscopyprovides areliableand effective clinical method for diagnosing MVPI.

[Keywords]velopharyngeal insufficiency；diagnosis；cleft palate；articulation

腭裂是人类最常见的颅颌面先天畸形之一，损害包括语言、进食和听力在内的诸多生理功能。（剩余12425字）