粘膜下口蓋裂の臨床統計的検討

• Published in: Journal of Japanese Cleft Palate Association Vol. 41; no. 1; pp. 24 - 30
• Main Authors: OMINATO Rei, KOBAYASHI Takanori, 児玉 泰光, 小山 貴寛, IKARASHI Yuki, IIDA Akihiko, 小野 和宏, 永田 昌毅, 髙木 律男
• Format: Journal Article
• Language: Japanese
• Published: 一般社団法人 日本口蓋裂学会 2016; Japanese Cleft Palate Association
• Subjects: clinical manifestation; diagnosis; submucous cleft palate; 粘膜下口蓋裂; 臨床病態; 診断
• ISSN: 0386-5185; 2186-5701
• DOI: 10.11224/cleftpalate.41.24

We evaluated the characteristics of 84 patients with submucous cleft palate who visited the Oral and Maxillofacial Surgery clinic at the Niigata University Medical and Dental Hospital between 1982 and 2012. The characteristics included gender, body weight at birth, age at diagnosis, chief complaint, occasion of diagnosis, other congenital anomalies, Calnan's triad, our treatment strategy, and mother's age at delivery. We diagnosed submucous cleft palate from soft palate muscle diastasis.The results were as follows:1) The subjects enrolled in this study were 42 males and 42 females.2) The age at diagnosis ranged from 9 days postpartum to 49 years with an average of 4.6 years.3) The most common chief complaint was speech symptoms in 59 patients (70.2%).4) The most common occasions for diagnosis were pediatric clinics in 26 patients (31.0%) and dental clinics in 21 patients (25.0%).5) The most common congenital anomaly was mental retardation in 28 patients (33.3%).6) As to Calnan's triad of submucous cleft palate, all three findings were present in 62 patients (73.8%).7) We suggested that palatoplasty, to normalize the primary anatomic abnormality, was the first step in improving velopharyngeal function. There were 60 patients (71.4%) in the surgically treated group, and 24 patients (28.6%) in the non-surgically treated group. 新潟大学医歯学総合病院顎顔面口腔外科において1982年から2012年の31年間に粘膜下口蓋裂と診断した84例を対象に，性別，出生時体重，初診時年齢，主訴，来院経路，合併症，Calnanの3徴候，治療内容および母親の出産時年齢について回顧的に検討した。なお，当科の粘膜下口蓋裂の診断基準は軟口蓋の筋層離開とした。その結果，以下の知見を得た。1) 性別は男性42例(50.0%)，女性42例(50.0%)であり，性差はみられなかった。2) 初診時年齢は生後9日から49歳にわたり，平均4.6歳であった。3) 主訴は構音や言語発達などの言語の異常に関する訴えが最も多く，59例(70.2%)であった。4) 当科への来院は小児科からの紹介が26例(31.0%)，他院歯科が21例(25.0%)であり，両者で半数以上を占めていた。5) 精神発達遅滞の合併は28例(33.3%)にみられた。6) Calnanの3徴候がすべて確認された症例は62例(73.8%)であった。7) 当科の初回手術は口蓋形成術とし，口蓋形成術を施行した症例は60例(71.4%)，施行しなかった症例は24例(28.6%)であった。