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目的探讨骨性Ⅲ类错畸形患者正颌手术对其语音功能的影响。方法经南京医科大学附属口腔医院正畸-正颌联合矫治中心诊断为上颌发育不足为主的骨性Ⅲ类错合患者26名,根据病史及专科检查分为两组:唇腭裂组(A组)10例,为先天性唇腭裂患者术后继发上颌骨发育不足;非唇腭裂组(B组)16例,均为单纯发育性骨性Ⅲ类错畸形。所有患者分别于术前、术后1月采集语音信息,对语音清晰度和6个元音(/a/、/o/、/e/、/i/、/u/、/ü/)的前三个共振峰频率进行差异性统计分析。结果 A组患者语音清晰度、/i/F1、/i/F2、/o/F2、/u/F2手术前后也发生了较为明显的变化,差异有统计学意义(P<0.05),其中语音清晰度的下降程度与上颌骨块前移的距离呈较好的相关性(r=0.8125);B组患者手术前后语音清晰度及各元音共振峰频率改变不明显,差异无统计学意义。结论正颌手术会加重唇腭裂继发骨性Ⅲ类错畸形患者腭咽闭合功能不全的程度,语音功能进一步恶化。单纯发育性畸形患者代偿性好,影响不明显。
Objective To investigate the effect of orthognathic surgery on speech function in patients with skeletal Class Ⅲ malocclusion. Methods Twenty-six patients with skeletal class Ⅲ malocclusion diagnosed by Orthodontics and Orthognathic Correction Center affiliated to Stomatological Hospital Affiliated to Nanjing Medical University were divided into two groups according to medical history and special examination: group A (cleft lip and palate) ), 10 cases of congenital cleft lip and palate in patients with secondary maxillary hypoplasia; non-cleft lip and palate group (B group) 16 cases, were purely developed skeletal Class Ⅲ malocclusion. All patients collected voice messages before and 1 month after surgery, respectively, for speech intelligibility and 6 vowels (/ a /, / o /, / e /, / i /, / u /, / u /) The first three formant frequencies were statistically analyzed. Results The speech intelligibility of patients in group A also had significant changes before and after the operation, with significant differences (P <0.05), among which speech There was a good correlation between the decrease of sharpness and the distance of maxillary advance (r = 0.8125). There was no significant difference in voice clarity and frequency of vowel formant between before and after operation in group B, the difference was not statistically significant. Conclusion Orthognathic surgery may aggravate the degree of velopharyngeal insufficiency in patients with cleft lip and palate secondary to type Ⅲ malformation. The speech function is further worsened. Simple deformity patients with compensatory good, the impact is not obvious.