Smahel Z, Horák I, Polivková H, Skvarilová B
Institute of Experimental Medicine, Czech Academy of Sciences, Prague.
Acta Chir Plast. 1992;34(4):204-14.
X-ray cephalometry was used for the assessment of the configuration of the skeletal and soft tissue profile in 81 adult males with isolated cleft palate. They were assessed in three subgroups, i. e. with complete and incomplete clefts and with clefts of the soft palate alone and were compared with a matched group of controls consisting of 50 normal males, as well as with the situation in the earlier examined series with unilateral cleft lip and palate. In isolated cleft palate both the upper and lower jaws were retruded. The maxilla was most markedly retruded in incomplete clefts and most slightly in clefts of the soft palate alone, while the mandible showed the smallest degree of retrusion in complete clefts. The configuration of the skeletal profile was similar as in unilateral cleft lip and palate, yet positive overjet was on the average restored in all types of isolated cleft palate. A more favourable configuration of the profile was present in patients with cleft soft palate alone, in the absence of an impairment of sagittal jaw relations. Changes in the configuration of the soft profile were due mainly to skeletal deviations. The retrusion of skeletal framework of the middle face was to a large degree masked by the larger thickness of the upper lip, in complete clefts also of the lower lip. Therefore the prominence of the upper lip was only slightly impaired and slight flattening of the face occurred only in complete clefts. The more horizontal slope of the columella resulted in a reduction of the nasolabial angle. Some deviations from the described pattern occurred in clefts of the soft palate alone (steeper slope of the upper lip with an unchanged nasolabial angle, normal thickness of the upper lip a. o.). The findings are suggestive of a differing facial physiognomy in isolated cleft palate.
采用X线头影测量法对81例成年孤立性腭裂男性患者的骨骼和软组织侧貌形态进行评估。他们被分为三个亚组，即完全性和不完全性腭裂组以及单纯软腭裂组，并与由50名正常男性组成的匹配对照组进行比较，同时也与早期检查的单侧唇腭裂系列情况进行比较。在孤立性腭裂患者中，上下颌均后缩。上颌在不完全性腭裂中后缩最明显，在单纯软腭裂中后缩最轻微，而下颌在完全性腭裂中后缩程度最小。骨骼侧貌形态与单侧唇腭裂相似，但在所有类型的孤立性腭裂中平均正覆盖均得以恢复。单纯软腭裂患者在矢状位颌关系未受损的情况下，侧貌形态更为有利。软组织侧貌形态的改变主要归因于骨骼偏差。中面部骨骼框架的后缩在很大程度上被上唇较厚的厚度所掩盖，在完全性腭裂中下唇厚度也较大。因此，上唇的突出仅略有受损，仅在完全性腭裂中出现轻微的面部扁平。鼻中隔较水平的倾斜导致鼻唇角减小。在单纯软腭裂中出现了一些与上述模式不同的情况（上唇斜率较陡，鼻唇角不变，上唇厚度正常等）。这些发现提示孤立性腭裂患者面部相貌存在差异。
