Kriens O
Department of Maxillofacial Surgery, Bremen, Germany.
Cleft Palate Craniofac J. 1991 Apr;28(2):157-68. doi: 10.1597/1545-1569_1991_028_0157_dodoic_2.3.co_2.
Maxillary plaster models of untreated infants with various cleft lip and palate forms have been studied under the Reflex Microscope. From the three- dimensional data processed by a PC, the specific dimensions of various cleft forms can be determined. Unexpected findings are that skeletal maxillary changes are present in infant velar clefts. The mid-sagittal maxillary length in particular becomes shorter with more severe clefting of the bony palate. From the morphologic point of view, Robin's sequence does not represent a specific entity, but usually a severe cleft of the hard palate. Unilateral clefts of lip, alveolus, and palate with a partial cleft lip reveal worse malformations than complete unilateral clefts. The morphologic changes recorded can be explained by a varying degree of lingual malposition. This reveals that displacements and malformations of infant cleft lip and palate are in fact secondary in nature. In correcting these secondary surface manifestations as soon as indicated by physiologic criteria one could hope for early normalization of sensation, perception, and function. Three-dimensional high-precision measurements are crucial for data-objective diagnoses, timing of therapy, choice of treatment, and in later evaluation of the results.
已在反射显微镜下对患有各种唇腭裂形式的未治疗婴儿的上颌石膏模型进行了研究。通过计算机处理的三维数据，可以确定各种腭裂形式的具体尺寸。意外发现是婴儿软腭裂中存在上颌骨骨骼变化。特别是随着硬腭裂隙加重，上颌矢状中线长度会变短。从形态学角度来看，罗宾序列并不代表一个特定实体，而通常是硬腭的严重裂隙。伴有部分唇裂的单侧唇、牙槽和腭裂比完全性单侧腭裂显示出更严重的畸形。记录到的形态学变化可以用不同程度的舌错位来解释。这表明婴儿唇腭裂的移位和畸形实际上是继发性的。一旦生理标准表明需要，尽早纠正这些继发性表面表现，有望使感觉、知觉和功能早日恢复正常。三维高精度测量对于数据客观诊断、治疗时机选择、治疗方案选择以及后期结果评估至关重要。
