Saperstein Elliot L, Kennedy Daniel L, Mulliken John B, Padwa Bonnie L
Department of Orthodontics and Pediatric Dentistry, The University of Michigan, Ann Arbor, MI, USA.
J Oral Maxillofac Surg. 2012 Jan;70(1):e66-71. doi: 10.1016/j.joms.2011.08.022.
Children with unoperated cleft lip/palate have nearly normal facial growth, whereas patients who have had labiopalatal repair often exhibit midfacial retrusion. The aim of this study was to compare cephalometric data in patients with repaired unilateral or bilateral complete cleft lip/alveolus (UCCLA or BCCLA) with patients with repaired unilateral or bilateral complete cleft lip/palate (UCCLP or BCCLP). This study might provide insight into the etiology of impaired facial growth in patients with repaired cleft lip/palate.
This was a retrospective, cross-sectional analysis of nonsyndromic patients with UCCLA, BCCLA, UCCLP, and BCCLP. Angular and linear measurements of the midfacial region were made on traced lateral cephalograms. Paired t tests were used to compare each group with normative controls from the Michigan Growth Study. Multivariate analysis of variance was used to determine possible differences among the groups.
There were 77 patients (38 male and 39 female) with a mean age of 11.2 years (range, 6 to 16 years; UCCLA, n = 25; BCCLA, n = 7; UCCLP, n = 18; and BCCLP, n = 27). There was no significant difference in midfacial position between the UCCLA and BCCLA groups and noncleft age-matched controls. In contrast, the maxilla in patients with UCCLP and BCCLP was significantly smaller and more retruded (P < .05) compared with patients with UCCLA and BCCLA and controls.
Children with UCCLA and BCCLA appear to have normal midfacial growth, whereas the maxilla in children with UCCLP and BCCLP is small and retrusive. This study suggests that the presence and/or repair of the secondary palate is responsible for midfacial hypoplasia in these patients.
未接受手术治疗的唇腭裂患儿面部生长近乎正常，而接受唇腭裂修复手术的患者常出现面中部后缩。本研究的目的是比较单侧或双侧完全性唇裂/牙槽突裂（UCCLA或BCCLA）修复患者与单侧或双侧完全性唇腭裂（UCCLP或BCCLP）修复患者的头影测量数据。本研究可能有助于深入了解唇腭裂修复患者面部生长受损的病因。
这是一项对非综合征性UCCLA、BCCLA、UCCLP和BCCLP患者的回顾性横断面分析。在描记的侧位头影测量片上对面中部区域进行角度和线性测量。采用配对t检验将每组与密歇根生长研究中的正常对照组进行比较。使用多因素方差分析来确定各组之间可能存在的差异。
共有77例患者（38例男性和39例女性），平均年龄11.2岁（范围6至16岁；UCCLA，n = 25；BCCLA，n = 7；UCCLP，n = 18；BCCLP，n = 27）。UCCLA组和BCCLA组与非腭裂年龄匹配对照组之间的面中部位置无显著差异。相比之下，与UCCLA组、BCCLA组及对照组相比，UCCLP组和BCCLP组患者的上颌骨明显更小且后缩更明显（P < 0.05）。
UCCLA和BCCLA患儿似乎面中部生长正常，而UCCLP和BCCLP患儿的上颌骨较小且后缩。本研究表明，继发腭的存在和/或修复是这些患者面中部发育不全的原因。
