Gaggl Alexander, Feichtinger Matthias, Schultes Günter, Santler Gert, Pichlmaier Margit, Mossböck Rudolf, Kärcher Hans
Department of Oral and Maxillofacial Surgery, University Hospital, Graz, Austria.
Cleft Palate Craniofac J. 2003 May;40(3):249-55. doi: 10.1597/1545-1569_2003_040_0249_caooia_2.0.co_2.
To assess differences in the aesthetic and functional long-term results of one-stage and two-stage surgical and orthodontic treatment in patients with cleft lip, palate, and alveolus.
Sixty adult patients who were operated on as children for unilateral cleft lip, palate, and alveolus were examined. In every patient the lip was closed using Tennison's technique. Thirty patients had soft and hard palate closure in two stages and 30 patients in a single stage. Lateral cephalometric and model analyses were conducted at a mean age of 18.4 years.
In the model analysis, transverse narrowing was seen in all patients after two-stage operations and in three patients after one-stage operations. The deficit was more severe in the molar region in the two-stage group and nearly similar in the premolar and molar region in the one-stage group. A sagittal deficiency in the anterior maxilla was found in 26 patients after two-stage operations and in 16 patients after one-stage operations. In the lateral cephalometric analysis, the mean sella-nasion-point A angle in the one- and two-stage group was 78.2 degrees and 76.8 degrees, respectively. The ANB angle was normal in both groups. In both groups the inclination of the midface was low. There was a low posterior facial height. Minor scarring was seen in the single-stage group.
A more severe impairment of growth of the maxilla in the sagittal and frontal plane was observed after two-stage operations on the cleft palate.
评估唇腭裂及牙槽突裂患者一期和二期手术及正畸治疗的美学和功能长期效果差异。
对60例儿童期接受单侧唇腭裂及牙槽突裂手术的成年患者进行检查。每位患者均采用坦尼森技术关闭唇部。30例患者分两期进行软硬腭关闭，30例患者一期完成。在平均年龄18.4岁时进行侧位头影测量和模型分析。
在模型分析中，两期手术患者及一期手术的3例患者均出现横向缩窄。两期手术组磨牙区的缺损更严重，一期手术组前磨牙和磨牙区缺损程度相近。两期手术患者中有26例、一期手术患者中有16例出现上颌前部矢状位不足。在侧位头影测量分析中，一期和两期手术组的平均蝶鞍-鼻根点A角分别为78.2度和76.8度。两组的ANB角均正常。两组患者的面中部倾斜度均较低，面部后高度也较低。一期手术组可见轻微瘢痕。
腭裂二期手术后观察到上颌在矢状面和额面的生长受到更严重的损害。
