华西口腔医学杂志2025，Vol.43Issue(3)：376-382,7.DOI:10.7518/hxkq.2025.2024425
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
Preliminary exploration and reliability analysis of clinical diagnostic method for marginal velopharyngeal insuffi-ciency
摘要
Abstract
Objective A stable,reliable,and easily implementable clinical diagnostic method for marginal velopha-ryngeal insufficiency(MVPI)was established on the basis of the subjective hearing judgement of hypernasality and ob-jective examination of velopharyngeal closure to address the lack of unified diagnostic criteria for MVPI.Methods Na-sopharyngeal fiberscopy and speech assessment results were collected from postoperative patients with cleft palate.These results were used to analyze the differences in the distribution of nasal resonance in patients with different velopha-ryngeal closure ratios and the correlation between velopharyngeal closure ratios and nasal resonance status.Mild-to-mod-erate hypernasality with its corresponding elopharyngeal closure ratio was employed to establish the diagnostic cri-teria of MVPI.The reproducibility of the criteria and whether the patients with MVPI diagnosed by using the criteria exhibited significantly different speech character-istics compared with other patients were verified.Re-suits A strong correlation was found between velopharyngeal closure ratios and nasal resonance(P＜0.001).Mild-to-moderate hypernasality mainly corresponded to velopharyngeal closure ratios ranging from 90％to 99％,and the combi-nation of the two characteristics as the diagnostic criteria for MVPI demonstrated good consistency(Kappa value=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.Conclusion Combining the subjective hearing judgement of mild-to-moderate hypernasality with velopharyn-geal closure ratios over 90％under nasopharyngeal fiberscopy provides a reliable and effective clinical method for diag-nosing MVPI.关键词
腭咽闭合不全/诊断/腭裂/构音Key words
velopharyngeal insufficiency/diagnosis/cleft palate/articulation分类
口腔医学引用本文复制引用
黄欣怡,毛奇蓉,尹恒,吴敏,石冰,郑谦,李精韬..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[J].华西口腔医学杂志,2025,43(3):376-382,7.基金项目
四川大学华西口腔医院探索与研发项目(LCYJ2022-YF-2) （LCYJ2022-YF-2）
四川省医学青年创新科研课题计划(Q23038) （Q23038）
四川省自然科学基金项目(2025ZNSFSC0769) Research and Development Program of West China Hospital of Stomatology,Sichuan University(LCYJ-2022-YF-2) （2025ZNSFSC0769）
Sichuan Medical Youth Innovation Research Project(Q23038) （Q23038）
Natural Science Foundation of Sichuan Province(2025ZNSFSC0769) （2025ZNSFSC0769）
