单纯言语治疗与言语治疗联合Furlow腭成形术治疗腭咽功能不全的比较：一项系统综述和荟萃分析

IF 2.4 3区医学 Q2 SURGERY

Journal of Plastic Reconstructive and Aesthetic Surgery Pub Date : 2025-07-22 DOI:10.1016/j.bjps.2025.07.014

Tim F.P. Ritzen , Nina Wijnants , Maud J.M. Verbeek , Shauni A.D. Caenen-Drummen , Sander M.J. van Kuijk , Darren I. Booi , René R.W.J. van der Hulst , Moustapha Hamdi , Rutger M. Schols

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引用次数: 0

摘要

目的探讨单纯言语治疗与言语治疗联合Furlow腭成形术治疗腭咽功能不全（VPI）的效果。设计对单纯言语治疗和言语治疗联合Furlow腭成形术治疗SMCP的VPI进行系统回顾和2项荟萃分析。在6大洲的10个不同国家设立二级和三级保健中心。患者、参与者的文章是在PubMed、Embase和Cochrane图书馆进行详细的文献检索后选择的。干预措施：单纯言语治疗和言语治疗联合Furlow腭成形术主要结局指标本研究的主要结局指标是治疗后vpi相关言语困难的减少。结果言语治疗对鼻音异常的风险差异（RD）仅为0.015 ~ 0.036；有鼻分泌物0.045分；补偿性发音为0.015分，难以理解的语音为0.089分。言语治疗联合Furlow腭成形术的RDs为0.46；鼻音增高、临床相关鼻音增高和鼻分泌物分别为0.29和0.37。结论单纯言语治疗和言语治疗联合Furlow腭成形术均可降低SMCP患者vpi相关的言语障碍。根据目前的研究结果，言语治疗应该伴随着Furlow手术矫正来治疗SMCP。然而，需要更大规模的前瞻性研究来调查语言治疗在轻度SMCP病例中作为独立干预的确切作用。

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Speech therapy only versus speech therapy combined with Furlow palatoplasty for the treatment of velopharyngeal insufficiency in submucous cleft palate: A systematic review and meta-analysis

Objective

The purpose of this review is to investigate the speech outcomes of speech therapy only versus speech therapy in combination with Furlow palatoplasty for the treatment of velopharyngeal insufficiency (VPI) in submucous cleft palate (SMCP).

Design

Systematic review and 2 meta-analyses of speech therapy only and speech therapy in combination with Furlow palatoplasty in the treatment of VPI in SMCP.

Setting

Secondary and tertiary care centres in 10 different countries spread over 6 continents.

Patients, participants

Articles were selected after an elaborate literature search using PubMed, Embase and the Cochrane Library.

Interventions

Speech therapy only and speech therapy in combination with Furlow palatoplasty

Main outcome measure

The primary outcome measure of this study is the reduction of VPI-associated speech difficulties after treatment.

Results

Speech therapy only showed a risk difference (RD) of 0.015 to 0.036 for the presence of hypernasality; 0.045 for the presence of nasal emission; 0.015 for the presence of compensatory articulation and 0.089 for the presence of unintelligible speech. Speech therapy in combination with Furlow palatoplasty showed RDs of 0.46; 0.29 and 0.37 for the presence of hypernasality, clinically relevant hypernasality and nasal emission, respectively.

Conclusion

Both speech therapy only and speech therapy in combination with Furlow palatoplasty demonstrate a decrease in VPI-associated speech difficulties in SMCP. According to the current findings, speech therapy should accompany surgical correction by Furlow for the treatment of SMCP. However, larger prospective studies are required to investigate the precise role of speech therapy as a standalone intervention in mild cases of SMCP.

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来源期刊

Journal of Plastic Reconstructive and Aesthetic Surgery 医学-外科

CiteScore

3.10

自引率

11.10%

发文量

578

审稿时长

3.5 months

期刊介绍： JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.