Semb G, Shaw W C
Department of Oral Health and Development, University Dental Hospital of Manchester, UK.
Acta Odontol Scand. 1998 Dec;56(6):352-5. doi: 10.1080/000163598428301.
Studies of the influence of surgery on facial growth in cleft lip and palate must take into account inherent variations in craniofacial form independent of surgery. Primary surgery, the most important iatrogenic influence on facial form, can differ in technique, timing, and sequence, and one of the major challenges in researching the topic is the remarkably varied clinical protocols in current use. Unfortunately, systematic attempts to compare dentofacial outcomes reported in the literature are unlikely to be reliable, as methodologic biases cannot be overcome. Rigorous intercenter studies can improve the dependability of data and provide evidence of the success of cleft services as a whole, but they are still subject to biases introduced by differences in surgical skills and underlying craniofacial form. These shortcomings are finally being overcome through multicenter randomized control trials.
关于手术对唇腭裂患者面部生长影响的研究必须考虑到与手术无关的颅面形态的固有差异。初次手术是对面部形态最重要的医源性影响因素，其在技术、时机和顺序上可能存在差异，而研究该主题的主要挑战之一是目前使用的临床方案差异极大。不幸的是，对文献中报道的牙颌面结果进行系统比较的尝试不太可能可靠，因为方法学偏差无法克服。严格的多中心研究可以提高数据的可信度，并提供整个腭裂治疗服务成功的证据，但它们仍会受到手术技能差异和潜在颅面形态差异所带来的偏差影响。这些缺点最终正通过多中心随机对照试验得以克服。
