Department of Pediatric Surgery, Institute of Mother and Child, Warsaw, Poland.
Orthod Craniofac Res. 2014 May;17(2):124-31. doi: 10.1111/ocr.12039. Epub 2014 Jan 13.
Facial appearance is important for normal psychosocial development in children with cleft lip and palate (CLP). There is conflicting evidence on how deficient maxillary growth may affect nasolabial esthetics.
We retrospectively investigated nasolabial appearance in two groups, the Langenback (35 children; mean age 11.1 years; range: 7.9-13.6) and Vomerplasty (58 children; mean age 10.8 years; range: 7.8-14), who received unilateral CLP surgery by the same surgeon. The hard palate repair technique differed between the two groups. In the Langenback group, palatal bone on the non-cleft side only was left denuded, inducing scar formation and inhibiting maxillary growth. In the Vomerplasty group, a vomerplasty with tight closure of the soft tissues on the palate was applied. Thirteen lay judges rated nasolabial esthetics on photographs using a modified Asher-McDade's index.
Nasolabial esthetics in both groups was comparable (p > 0.1 for each nasolabial component). Inferior view was judged as the least esthetic component and demonstrated mean scores 3.18 (SD = 0.63) and 3.13 (SD = 0.47) in the Langenback and Vomerplasty groups, respectively. Mean scores for other components were from 2.52 (SD = 0.63) to 2.81 (SD = 0.62). Regression analysis showed that vomerplasty is related with slight improvement in the nasal profile only (coefficient B = -0.287; p = 0.043; R(2 ) = 0.096).
This study demonstrates that the use of vomerplasty instead of the Langenbeck technique is weakly associated with the nasolabial appearance among pre-adolescent patients with UCLP.
面部外观对于唇腭裂（CLP）患儿的正常心理社会发展很重要。上颌骨生长不足如何影响鼻唇美学，目前存在相互矛盾的证据。
我们回顾性调查了由同一位外科医生行单侧 CLP 手术的两组患儿的鼻唇外观，分别为 Langenback 组（35 例；平均年龄 11.1 岁；范围：7.9-13.6 岁）和 Vomerplasty 组（58 例；平均年龄 10.8 岁；范围：7.8-14 岁）。两组的硬腭裂修复技术不同。在 Langenback 组中，非裂隙侧的腭骨仅被裸露，导致瘢痕形成并抑制上颌骨生长。在 Vomereplasty 组中，应用了带有硬腭软组织紧密闭合的 Vomereplasty。13 位非专业评判人员使用改良的 Asher-McDade 指数对照片进行鼻唇美学评分。
两组的鼻唇美学评分相当（每个鼻唇成分的 p > 0.1）。下视图被评为最不美观的成分，Langenback 和 Vomereplasty 组的平均评分分别为 3.18（SD = 0.63）和 3.13（SD = 0.47）。其他成分的平均评分范围为 2.52（SD = 0.63）至 2.81（SD = 0.62）。回归分析表明，Vomerplasty 仅与轻微改善鼻侧轮廓有关（系数 B = -0.287；p = 0.043；R² = 0.096）。
本研究表明，与 Langenbeck 技术相比，在 UCLP 患儿中，使用 Vomereplasty 与鼻唇外观弱相关。
