Saleh Mohamed A, Elshahat Ahmed, Emara Maher, Hussein Heba, Gould Lisa, Smith David, Awad Mostafa A
Plastic Surgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
J Craniofac Surg. 2011 Jul;22(4):1435-9. doi: 10.1097/SCS.0b013e31821d17d3.
Correction of cleft lip nasal deformity is an elusive goal. A controversy exists regarding the cause of the deformity, and therefore, there is a controversy of how to correct the deformity. Extrinsic theory is based on the presence of deformational forces from outside. The intrinsic theory is associated with deficiency of the lower lateral cartilage. The aim of this study was to use new objective tools to compare morphologically and histologically between the lower lateral cartilages of cleft and noncleft sides in patients with unilateral cleft lip nasal deformity. This study included 16 patients. They were operated on to correct unilateral cleft lip nasal deformity. Length, width, and thickness of lateral crura of the lower lateral cartilages of cleft and noncleft sides were measured. Punch biopsies from the middle part of the caudal ends of lateral crura were taken and sent for histologic and immunohistochemical studies. The lateral crura of the cleft side were significantly wider and shorter and tend to be thinner than those of the noncleft side. There was no significant difference in the chondroblast, chondrocyte, and total cellular number in the lower lateral cartilage of the cleft and noncleft sides. There was significantly less glycosaminoglycan content in the ground matrix of the lower lateral cartilage of cleft side. In conclusion, the use of digital sliding caliber in measuring the diminutions of the lower lateral cartilage and image analyzer to quantify the proteoglycans, glycosaminoglycans, fibroblast growth factor 18, and collagen content is very effective objective tools to compare the cleft and noncleft alar cartilage.
唇裂鼻畸形的矫正一直是个难以实现的目标。关于该畸形的成因存在争议，因此，对于如何矫正该畸形也存在争议。外在理论基于外部存在的变形力。内在理论则与下外侧软骨的缺陷有关。本研究的目的是使用新的客观工具，对单侧唇裂鼻畸形患者裂侧和非裂侧的下外侧软骨进行形态学和组织学比较。本研究纳入了16例患者。他们接受了单侧唇裂鼻畸形矫正手术。测量了裂侧和非裂侧下外侧软骨外侧脚的长度、宽度和厚度。从外侧脚下端中部取打孔活检组织，送去进行组织学和免疫组织化学研究。裂侧的外侧脚明显更宽、更短，且往往比非裂侧更薄。裂侧和非裂侧下外侧软骨中的成软骨细胞、软骨细胞和细胞总数没有显著差异。裂侧下外侧软骨基质中的糖胺聚糖含量明显更少。总之，使用数字滑动卡尺测量下外侧软骨的减小情况，并使用图像分析仪量化蛋白聚糖、糖胺聚糖、成纤维细胞生长因子18和胶原蛋白含量，是比较裂侧和非裂侧鼻翼软骨的非常有效的客观工具。
