Clark Stacey L, Teichgraeber John F, Fleshman Ruth G, Shaw Joi D, Chavarria Carmen, Kau Chung-How, Gateno Jaime, Xia James J
Department of Otolaryngology-Head and Neck Surgery, the University of Health Science Center at Houston, Texas, USA.
J Craniofac Surg. 2011 Jan;22(1):333-6. doi: 10.1097/SCS.0b013e318200d874.
The purpose of this study was to evaluate the long-term effectiveness of presurgical nasoalveolar molding (PNAM) in patients with unilateral cleft lip and palate (UCLP).
Twenty-five patients with UCLP treated by either PNAM or non-PNAM therapy between 1998 and 2003 were recruited in the study. During the clinical examination and data analysis, the evaluators were blinded to which patients received PNAM. The patients were reviewed clinically, and their facial morphology was captured with a three-dimensional scanner. Their dental arch configuration and occlusion were recorded by plaster dental models. After the patient evaluations and measurements were completed, the patient list was unblinded. There were 20 patients in the PNAM group and 5 patients in the non-PNAM group. Fisher exact tests and Wilcoxon rank sum tests were used to compare the outcomes.
Clinically, the improvement in the PNAM group was most evident in nasal and lip anatomy. However, there were no statistically significant differences between the 2 groups on each of the measurements on three-dimensional facial images and dental models.
Our study suggests a trend toward a long-term clinical improvement in nasal and lip anatomy of UCLP patients treated with PNAM. However, these improved results were not confirmed by three-dimensional stereophotography. There was no statistically significant difference in the long-term three-dimensional anthropometric measurements and dental model analysis between the PNAM group and the non-PNAM group.
本研究旨在评估术前鼻牙槽塑形（PNAM）对单侧唇腭裂（UCLP）患者的长期疗效。
本研究招募了1998年至2003年间接受PNAM或非PNAM治疗的25例UCLP患者。在临床检查和数据分析过程中，评估人员对哪些患者接受了PNAM治疗并不知情。对患者进行临床检查，并用三维扫描仪采集其面部形态。通过石膏牙模记录其牙弓形态和咬合情况。在完成患者评估和测量后，公布患者名单。PNAM组有20例患者，非PNAM组有5例患者。采用Fisher精确检验和Wilcoxon秩和检验比较结果。
临床上，PNAM组在鼻和唇解剖结构方面的改善最为明显。然而，在三维面部图像和牙模的各项测量上，两组之间没有统计学上的显著差异。
我们的研究表明，接受PNAM治疗的UCLP患者在鼻和唇解剖结构方面有长期临床改善的趋势。然而，这些改善结果未得到三维立体摄影的证实。PNAM组和非PNAM组在长期三维人体测量和牙模分析方面没有统计学上的显著差异。
