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三种不同手术方案治疗完全性单侧唇腭裂的颅面形态学结果:一项初步研究。

Craniofacial morphological outcome following treatment with three different surgical protocols for complete unilateral cleft lip and palate: a premilinary study.

机构信息

Craniofacial Centre, Warsaw, Poland.

出版信息

Int J Oral Maxillofac Surg. 2010 Feb;39(2):122-8. doi: 10.1016/j.ijom.2009.12.012. Epub 2010 Jan 18.

Abstract

This study compared craniofacial morphology between three groups of children with complete unilateral cleft lip and palate, treated with different surgical protocols. The study included 66 10-year-old children (42 boys and 20 girls) with a complete unilateral cleft lip and palate (22 patients in each of the three groups). Children aged 7 months underwent one-stage surgery, performed by a single surgeon. During surgery, the soft and hard palate and the lip underwent correction. The difference between the groups depended on the hard palate closure. Group I patients had the mucoperiosteal flap elevated on both sides of the cleft. Group II patients had the mucoperiosteal flap elevated on the non-cleft side, and had only a minimal 2-3mm mucoperiosteal flap elevated on the cleft side. Group III patients had mucoperiostium elevated from the septum vomer to create a single-layered caudally pedicled flap, and had only a minimal 2-3mm palatal flap elevated on the cleft side. Craniofacial morphology was defined using lateral cephalometric analysis. Significant craniofacial morphological differences were identified between groups I, II and III. Group III demonstrated the most favourable morphology. This indicates that the technique of hard palate closure has significant influence on craniofacial growth and development.

摘要

本研究比较了三组接受不同手术方案治疗的完全性单侧唇腭裂儿童的颅面形态。研究纳入了 66 名 10 岁儿童(男 42 名,女 20 名),均为完全性单侧唇腭裂。7 月龄时,所有儿童均由同一位外科医生行一期手术,同期行软硬腭裂修复和唇裂修复。三组患儿的硬腭裂关闭方式不同。组 I 患儿在裂隙两侧掀起黏骨膜瓣;组 II 患儿在非裂隙侧掀起黏骨膜瓣,仅在裂隙侧掀起 2-3mm 的黏骨膜瓣;组 III 患儿从鼻中隔到犁骨掀起黏膜骨膜瓣,形成单层尾侧蒂瓣,仅在裂隙侧掀起 2-3mm 的腭瓣。采用侧位头颅分析法定义颅面形态。组 I、II 和 III 之间存在显著的颅面形态差异。组 III 显示出最有利的形态。这表明硬腭裂关闭技术对颅面生长发育有显著影响。

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