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[唇腭裂的鉴别诊断与治疗]

[Differential diagnosis and treatment of cheilognathopalatoschises].

作者信息

Bull H-G, Lenzen C

机构信息

Klinik f. MKG-Chirurgie/Plastische Operationen, St. Josefshospital Krefeld.

出版信息

Zentralbl Gynakol. 2003 Oct;125(10):398-403. doi: 10.1055/s-2003-44482.

Abstract

Cleft lip, alveolous and palate is the second frequent malformation in Europe with an incidence of 1 : 500. Pertaining to ontogeny it must be differentiated between cleft lip and alveolous and cleft palate. Cleft lip and cleft lip and alveolous can occur unilateral, right or left, or bilateral. Cleft bony palate can also occur unilateral, right or left, or bilateral, but cleft velum only in the median plane. Diagnostic and treatment of cleft lip and palate call for interdisciplinary cooperation between gynecologist/obstetrician, cranio-maxillo-facial surgeon, pediatrician, otorhinolaryngologist, orthodontist and logopedist. The schedule of primary cleft surgery in Germany is marked by a more-stage concept, in which at the end of the second year of life cleft lip and palate except cleft alveolous should be closed up. Despite of most careful surgery patients with cleft lip and palate can show functional and aesthetic disturbances. The functional disorders can affected masticatory function, speech, hearing and nasal breathing. Aesthetics disorders can be concerned to skeletal or soft tissue deformities of lip and nose. Operative corrections of bone and soft tissue can rehabilitate these patients entirely from functional and aesthetic view.

摘要

唇腭裂(包括唇、牙槽突和腭部)是欧洲第二常见的畸形,发病率为1:500。从个体发育来看,必须区分唇裂和牙槽突裂与腭裂。唇裂和唇裂合并牙槽突裂可单侧发生,右侧或左侧,也可双侧发生。骨性腭裂也可单侧发生,右侧或左侧,或双侧发生,但软腭裂仅发生在正中平面。唇腭裂的诊断和治疗需要妇科医生/产科医生、颅颌面外科医生、儿科医生、耳鼻喉科医生、正畸医生和言语治疗师之间的跨学科合作。德国原发性腭裂手术的时间表以多阶段概念为特点,即在生命的第二年结束时,除腭裂外的唇腭裂应予以修复。尽管手术非常精细,但唇腭裂患者仍可能出现功能和美观方面的问题。功能障碍可能影响咀嚼功能、言语、听力和鼻呼吸。美观问题可能涉及唇部和鼻部的骨骼或软组织畸形。对骨骼和软组织进行手术矫正可以从功能和美观的角度使这些患者完全康复。

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