Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.004
Pablo Antonio Ysunza MD, PhD, CCC-SLP, CNIM
Velopharyngeal insufficiency (VPI) must be corrected by a surgical procedure or a prosthetic appliance. Both options must be customized according to imaging findings as provided by videonasopharyngoscopy (VNP) and multiplanar videofluoroscopy (MPVF). The purpose of this chapter is to describe the appropriate performance of VNP and MPVF for planning the surgical procedure for correcting VPI. VNP and MPVF provide the necessary information for planning the surgical treatment of VPI with the highest probability of success.
{"title":"Imaging in velopharyngeal insufficiency assessment","authors":"Pablo Antonio Ysunza MD, PhD, CCC-SLP, CNIM","doi":"10.1016/j.otot.2025.10.004","DOIUrl":"10.1016/j.otot.2025.10.004","url":null,"abstract":"<div><div>Velopharyngeal insufficiency (VPI) must be corrected by a surgical procedure or a prosthetic appliance. Both options must be customized according to imaging findings as provided by videonasopharyngoscopy (VNP) and multiplanar videofluoroscopy (MPVF). The purpose of this chapter is to describe the appropriate performance of VNP and MPVF for planning the surgical procedure for correcting VPI. VNP and MPVF provide the necessary information for planning the surgical treatment of VPI with the highest probability of success.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 258-261"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Velopharyngeal insufficiency (VPI) is a condition characterized by incomplete closure of the velopharyngeal sphincter, leading to hypernasality, nasal air escape, and speech intelligibility issues. The Furlow double opposing Z-plasty technique has emerged as an effective surgical approach for treating VPI by improving velopharyngeal closure through soft tissue reconfiguration. This technique can be performed with various palate widths and heights, in addition to different cleft types. Surgical indications, procedural steps, postoperative outcomes, and complications are discussed.
{"title":"Furlow double opposing Z-Plasty for treatment of VPI","authors":"Omri Emodi MD, DMD , Tal Capucha DMD, PhD , Michal Even-Almos MD, DMD , Andrie Krasovsky DMD , Chaim Ohayon DMD , Amir Bilder DMD, MSc , Nidal Zeineh DMD, PhD","doi":"10.1016/j.otot.2025.10.007","DOIUrl":"10.1016/j.otot.2025.10.007","url":null,"abstract":"<div><div>Velopharyngeal insufficiency (VPI) is a condition characterized by incomplete closure of the velopharyngeal sphincter, leading to hypernasality, nasal air escape, and speech intelligibility issues. The Furlow double opposing Z-plasty technique has emerged as an effective surgical approach for treating VPI by improving velopharyngeal closure through soft tissue reconfiguration. This technique can be performed with various palate widths and heights, in addition to different cleft types. Surgical indications, procedural steps, postoperative outcomes, and complications are discussed.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 268-272"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.005
Matan Katz MD, Yaniv Ebner MD, BPharm
Cleft palate repair is a cornerstone procedure in the management of children with cleft palate, with a significant impact on feeding, speech, hearing, and craniofacial development. This chapter outlines a progressive, anatomy-based surgical strategy for cleft palate repair, emphasizing individualized decision-making based on intraoperative findings. Beginning with intervelar veloplasty and escalating only when needed to lateral relaxing incisions, vomer flap use, or posterior pushback techniques, the approach prioritizes the restoration of the levator veli palatini sling, tension-free closure, and minimal scarring of the hard palate. Key technical steps, including meticulous muscle dissection and layered closure of nasal and oral mucosa, are described in detail. Special consideration should be given to airway implications in pediatric patients, as well as the role of the otolaryngologist in managing concurrent Eustachian tube dysfunction. An additional option, the Furlow double-opposing Z-plasty, is briefly presented as an alternative technique for select cases. This chapter integrates embryological understanding, surgical technique, and long-term functional goals to optimize velopharyngeal competence and reduce complications such as fistulae or velopharyngeal insufficiency (VPI). Cleft lip is beyond the scope of this chapter and does not result in VPI.
{"title":"Cleft palate repair for velopharyngeal insufficiency","authors":"Matan Katz MD, Yaniv Ebner MD, BPharm","doi":"10.1016/j.otot.2025.10.005","DOIUrl":"10.1016/j.otot.2025.10.005","url":null,"abstract":"<div><div>Cleft palate repair is a cornerstone procedure in the management of children with cleft palate, with a significant impact on feeding, speech, hearing, and craniofacial development. This chapter outlines a progressive, anatomy-based surgical strategy for cleft palate repair, emphasizing individualized decision-making based on intraoperative findings. Beginning with intervelar veloplasty and escalating only when needed to lateral relaxing incisions, vomer flap use, or posterior pushback techniques, the approach prioritizes the restoration of the levator veli palatini sling, tension-free closure, and minimal scarring of the hard palate. Key technical steps, including meticulous muscle dissection and layered closure of nasal and oral mucosa, are described in detail. Special consideration should be given to airway implications in pediatric patients, as well as the role of the otolaryngologist in managing concurrent Eustachian tube dysfunction. An additional option, the Furlow double-opposing Z-plasty, is briefly presented as an alternative technique for select cases. This chapter integrates embryological understanding, surgical technique, and long-term functional goals to optimize velopharyngeal competence and reduce complications such as fistulae or velopharyngeal insufficiency (VPI). Cleft lip is beyond the scope of this chapter and does not result in VPI.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 262-267"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.012
Gil Zoizner-Agar MD
Middle ear pathology, most commonly otitis media with effusion accompanied by hearing loss, is almost universal in patients with cleft palate. This poses further challenges to an already complex patient population. Ventilation tube insertion provides an immediate solution, in theory, to middle ear effusion and pressure equalization. In practice, optimal management of the middle ear in patients with a cleft palate is still controversial, with inconclusive evidence to guide when, and even if, to place ventilation tubes. A review of current evidence will be presented regarding pathophysiology and incidence of middle ear disease in this population, as well as considerations to guide management.
{"title":"Management of the middle ear in patients with cleft palate","authors":"Gil Zoizner-Agar MD","doi":"10.1016/j.otot.2025.10.012","DOIUrl":"10.1016/j.otot.2025.10.012","url":null,"abstract":"<div><div>Middle ear pathology, most commonly otitis media with effusion accompanied by hearing loss, is almost universal in patients with cleft palate. This poses further challenges to an already complex patient population. Ventilation tube insertion provides an immediate solution, in theory, to middle ear effusion and pressure equalization. In practice, optimal management of the middle ear in patients with a cleft palate is still controversial, with inconclusive evidence to guide when, and even if, to place ventilation tubes. A review of current evidence will be presented regarding pathophysiology and incidence of middle ear disease in this population, as well as considerations to guide management.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 290-294"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.003
Karen J. Golding-Kushner PhD
Velopharyngeal insufficiency (VPI) is a structural disorder characterized by inadequate closure of the velopharyngeal (VP) port during speech, leading to hypernasality and nasal air escape. Diagnosis is confirmed through imaging techniques, such as nasendoscopy or videofluoroscopy, performed during speech tasks. Speech-language pathologists play a crucial role in the assessment and management of VPI, informing decisions on therapy initiation, imaging readiness, and postoperative care. In cases of language delay, therapy should focus on integrating language goals with articulation therapy, emphasizing accurate sound production to enhance intelligibility and overall communication effectiveness. Speech therapy is crucial for addressing maladaptive compensatory articulation errors, such as glottal stops, even prior to surgical intervention. Postoperative therapy involves continued articulation work and monitoring for persistent symptoms, with referrals for further imaging if necessary. This comprehensive approach underscores the Speech-language pathologist’s role in the multidisciplinary management of VPI.
{"title":"Speech and language pathologist velopharyngeal insufficiency treatments","authors":"Karen J. Golding-Kushner PhD","doi":"10.1016/j.otot.2025.10.003","DOIUrl":"10.1016/j.otot.2025.10.003","url":null,"abstract":"<div><div>Velopharyngeal insufficiency (VPI) is a structural disorder characterized by inadequate closure of the velopharyngeal (VP) port during speech, leading to hypernasality and nasal air escape. Diagnosis is confirmed through imaging techniques, such as nasendoscopy or videofluoroscopy, performed during speech tasks. Speech-language pathologists play a crucial role in the assessment and management of VPI, informing decisions on therapy initiation, imaging readiness, and postoperative care. In cases of language delay, therapy should focus on integrating language goals with articulation therapy, emphasizing accurate sound production to enhance intelligibility and overall communication effectiveness. Speech therapy is crucial for addressing maladaptive compensatory articulation errors, such as glottal stops, even prior to surgical intervention. Postoperative therapy involves continued articulation work and monitoring for persistent symptoms, with referrals for further imaging if necessary. This comprehensive approach underscores the Speech-language pathologist’s role in the multidisciplinary management of VPI.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 255-257"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.002
Yaniv Ebner MD, BPharm
A thorough understanding of palatal anatomy and velopharyngeal function is fundamental to the pediatric otolaryngologist managing children with speech disorders and cleft-related anomalies. The hard palate provides a passive structural partition between the oral and nasal cavities, while the soft palate acts as a dynamic sphincter—essential for normal speech resonance, effective swallowing, and nasal airway patency. This review details the embryologic origins, structural anatomy, and muscular components of the palate, with emphasis on the functional interplay of the levator veli palatini, tensor veli palatini, palatoglossus, and palatopharyngeus muscles in forming the velopharyngeal sphincter (VPS). Key patterns of velopharyngeal closure—coronal, sagittal, circular, and circular with Passavant’s ridge—are reviewed in the context of normal and pathologic speech production. Special attention is given to the altered anatomy observed in cleft palate, including aberrant muscle orientation and insertion in the cleft velum, and the clinical implications for surgical repair and postoperative speech outcomes. Submucous cleft palate is also addressed, highlighting its often-delayed diagnosis and characteristic anatomical features. This comprehensive anatomical and functional review aims to support clinical decision-making and surgical planning in the care of children with velopharyngeal dysfunction.
{"title":"Palate and velo-pharyngeal sphincter anatomy and function","authors":"Yaniv Ebner MD, BPharm","doi":"10.1016/j.otot.2025.10.002","DOIUrl":"10.1016/j.otot.2025.10.002","url":null,"abstract":"<div><div>A thorough understanding of palatal anatomy and velopharyngeal function is fundamental to the pediatric otolaryngologist managing children with speech disorders and cleft-related anomalies. The hard palate provides a passive structural partition between the oral and nasal cavities, while the soft palate acts as a dynamic sphincter—essential for normal speech resonance, effective swallowing, and nasal airway patency. This review details the embryologic origins, structural anatomy, and muscular components of the palate, with emphasis on the functional interplay of the levator veli palatini, tensor veli palatini, palatoglossus, and palatopharyngeus muscles in forming the velopharyngeal sphincter (VPS). Key patterns of velopharyngeal closure—coronal, sagittal, circular, and circular with Passavant’s ridge—are reviewed in the context of normal and pathologic speech production. Special attention is given to the altered anatomy observed in cleft palate, including aberrant muscle orientation and insertion in the cleft velum, and the clinical implications for surgical repair and postoperative speech outcomes. Submucous cleft palate is also addressed, highlighting its often-delayed diagnosis and characteristic anatomical features. This comprehensive anatomical and functional review aims to support clinical decision-making and surgical planning in the care of children with velopharyngeal dysfunction.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 250-254"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.009
Yair Donin MD, Yaniv Ebner MD, BPharm
Orticochea sphincter pharyngoplasty is a dynamic surgical technique designed to address velopharyngeal insufficiency (VPI) by reconstructing a functional velopharyngeal sphincter using palatopharyngeal flaps. This article provides a step-by-step operative guide to the Orticochea procedure, emphasizing critical technical nuances, patient selection, and postoperative considerations. The technique is particularly beneficial in patients with poor lateral wall motion and a coronal pattern of closure.
{"title":"Sphincter Pharyngoplasty","authors":"Yair Donin MD, Yaniv Ebner MD, BPharm","doi":"10.1016/j.otot.2025.10.009","DOIUrl":"10.1016/j.otot.2025.10.009","url":null,"abstract":"<div><div>Orticochea sphincter pharyngoplasty is a dynamic surgical technique designed to address velopharyngeal insufficiency (VPI) by reconstructing a functional velopharyngeal sphincter using palatopharyngeal flaps. This article provides a step-by-step operative guide to the Orticochea procedure, emphasizing critical technical nuances, patient selection, and postoperative considerations. The technique is particularly beneficial in patients with poor lateral wall motion and a coronal pattern of closure.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 282-284"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.006
Yaniv Ebner MD, BPharm, Yair Donin MD
Midline posterior myo-mucosal pharyngeal flap is the main “workhorse” surgery for the correction of velopharyngeal (VP) insufficiency. This technique is most suitable for large incompetency of the VP sphincter, which do have lateral pharyngeal wall motion. The superiorly based flap is elevated from the posterior pharyngeal wall, rotated, and attached to the soft palate (velum), to obstruct the center of the VP sphincter, while leaving lateral ports on its sides to allow nasal breathing and proper nasal sounds (n, m, ng) pronounce. Stages of the surgery include flap elevation, velar recipient site preparation, suturing flap free end to velum to create a tissue bridge between the posterior pharyngeal wall to the velum, and approximation of donor site. This surgery has excellent success rate in solving VP insufficiency when tailored to suitable patients selected by pre-operative ENT and Speech and Language Pathologist evaluation. Possible complications include sleep disordered breathing and nasal obstruction; both can be mitigated by proper design of the flap to be superior enough and with bilateral patent lateral ports.
后中线肌粘膜咽瓣是矫正腭咽功能不全的主要手术。这项技术最适合于有咽壁外侧运动的副副括约肌功能不全的患者。上基瓣从咽后壁抬高，旋转并附着在软腭（腭膜）上，阻塞副副括约肌的中心，同时在其两侧留下外侧口，以允许鼻腔呼吸和正确的鼻音（n, m, ng）发音。手术阶段包括皮瓣提升，掌膜受体部位准备，将皮瓣游离端缝合至掌膜，在咽后壁与掌膜之间建立组织桥，以及接近供区。通过术前耳鼻喉科和语言病理学家评估选择合适的患者，该手术解决VP功能不全的成功率很高。可能的并发症包括睡眠呼吸障碍和鼻塞；这两种情况都可以通过适当的皮瓣设计来缓解，使其足够优越，并具有双侧专利侧口。
{"title":"Pharyngeal flap","authors":"Yaniv Ebner MD, BPharm, Yair Donin MD","doi":"10.1016/j.otot.2025.10.006","DOIUrl":"10.1016/j.otot.2025.10.006","url":null,"abstract":"<div><div>Midline posterior myo-mucosal pharyngeal flap is the main “workhorse” surgery for the correction of velopharyngeal (VP) insufficiency. This technique is most suitable for large incompetency of the VP sphincter, which do have lateral pharyngeal wall motion. The superiorly based flap is elevated from the posterior pharyngeal wall, rotated, and attached to the soft palate (velum), to obstruct the center of the VP sphincter, while leaving lateral ports on its sides to allow nasal breathing and proper nasal sounds (n, m, ng) pronounce. Stages of the surgery include flap elevation, velar recipient site preparation, suturing flap free end to velum to create a tissue bridge between the posterior pharyngeal wall to the velum, and approximation of donor site. This surgery has excellent success rate in solving VP insufficiency when tailored to suitable patients selected by pre-operative ENT and Speech and Language Pathologist evaluation. Possible complications include sleep disordered breathing and nasal obstruction; both can be mitigated by proper design of the flap to be superior enough and with bilateral patent lateral ports.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 278-281"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.10.008
Michal Benkler MD , Robert J. Mann MD
The cleft palate is sometimes viewed as a gap where the normal anatomy is separated. Instead, we suggest looking at it as a void created by the absence of tissue. Multiple tissue types are entirely missing, thus severely impacting both form and function. The goal should therefore be to replace the absent tissue and not simply to pull the cleft “gap” back together. We believe that those who receive buccal flap repair will present with a longer and more effective velum. We present an effective technique, providing palatal closure without tension, good muscular reconstruction, lengthening of the nasal layer, and no raw surfaces.
{"title":"Buccal flap for velopharyngeal insufficiency and cleft palate reconstruction","authors":"Michal Benkler MD , Robert J. Mann MD","doi":"10.1016/j.otot.2025.10.008","DOIUrl":"10.1016/j.otot.2025.10.008","url":null,"abstract":"<div><div>The cleft palate is sometimes viewed as a gap where the normal anatomy is separated. Instead, we suggest looking at it as a void created by the absence of tissue. Multiple tissue types are entirely missing, thus severely impacting both form and function. The goal should therefore be to replace the absent tissue and not simply to pull the cleft “gap” back together. We believe that those who receive buccal flap repair will present with a longer and more effective velum. We present an effective technique, providing palatal closure without tension, good muscular reconstruction, lengthening of the nasal layer, and no raw surfaces.</div></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Pages 273-277"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.otot.2025.12.002
{"title":"Statement of Ownership","authors":"","doi":"10.1016/j.otot.2025.12.002","DOIUrl":"10.1016/j.otot.2025.12.002","url":null,"abstract":"","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"36 4","pages":"Page I"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号