@article{oai:niigata-u.repo.nii.ac.jp:00025869,
 author = {磯野, 信策},
 issue = {1},
 journal = {新潟歯学会雑誌, 新潟歯学会雑誌},
 month = {Jul},
 note = {Velopharyngeal competency and articulation in 70 patients with cleft lip and palate were examined over a period of years following two-stage palatoplasty combined with Hotz's plate, and were investigated the outcome of this treatment in terms of speech condition on the basis of evaluations at the age of 8 years. The results were shown below. 1.Velopharyngeal competency at 8 years of age was competent in 84.3%, marginal in 5.7%, incompetent in 10.0%, indicating favorable velopharyngeal competency in most subjects. Chronological follow-up of velopharyngeal competency revealed marked long-term improvement even after the hard palate closure operation, which was the characteristic of this treatment system. 2. Fifty-three subjects (75.7%) have achieved normal articulation at 8 years of age. Normal articulation developed without the occurrence of compensatory articulation in 6 subjects, compensatory articulation transiently occured but spontaneously improved in 12 subjects, and articulation treatment had been completed in 35. While quite a few subjects required articulation treatment, appropriate therapy resulted in favorable improvement by the age of 8 years. 3.It should be suitable to evaluate speech results at the age of 8 years, when the hard palate closlng surgery had been completed and velopbaryngeal competency had become stable. This study suggested that the results of speech therapy must be included in evaluation, and that speech therapy is important in this treatment system These findings indicate that two-stage palatoplasty combined with Hotz's plate is a treatment system that requires a variety of types of elaborate care, and that a elaborate treatment plan and long-term care are also necessary to speech therapy. It is possible to achieve normal development of the jaw and normal speech with this treatment system, if appropriate medical treatment is provided and satisfactory speech therapy is included as part of the team approach., Hotz床併用二段階口蓋形成手術法を行った唇顎口蓋裂一次症例70例について鼻咽腔閉鎖機能と構音を経年的に観察し、8歳時の評価により本治療法の言語成績を検討して以下の結果を得た。1. 8歳時における鼻咽腔閉鎖機能は｢良好｣59例(84.3%)、｢軽度不全｣4例(5.7%)、｢不全｣7例(10.0%)であり、良好な鼻咽腔閉鎖機能が得られていた｡経年的に観察すると硬口蓋閉鎖手術後まで長期にわたって機能の改善が顕著にみられ、これが本治療体系の特徴と考えられた｡2.正常構音を獲得していたものは53例(75.7%)で異常構音の発現をみずに正常な構音発達をみたものが6例、一過性に異常構音をみたが自然消失したものが12例、構音治療が終了したものが35例であった｡構音治療を必要とする症例が多かったが、適切な構音治療により8歳までには良好な改善が得られた｡3. 本治療法における言語成績の評価は、手術が完了した硬口蓋閉鎖手術後に鼻咽腔閉鎖機能が安定する8歳頃に行うことが適当と思われ、その場合では言語治療の成績も評価に含まれることになる｡以上から、Hotz床併用二段階口蓋形成手術法は種々の緻密なケアを必要とする治療体系といえるが、言語に関しても同様に緻密な治療計画と長期のケアが必要である｡本治療体系では医学面から適切な治療が行われ、しかも、チームアプローチの一環として言語治療が十分に機能していれば、正常な顎発育とともに正常な言語を獲得させることが可能であると考えられた｡},
 pages = {15--24},
 title = {Hotz 床併用二段階口蓋形成手術法を実施した唇顎口蓋患裂児の言語発達に関する研究 : 言語成績を中心に},
 volume = {28},
 year = {1998}
}