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手术修复的单侧唇腭裂患者的关节盂窝位置

Glenoid fossa position in surgically repaired unilateral cleft lip and palate patients.

作者信息

Sundareswaran Shobha, Nipun Cheerkoly Appunninair

机构信息

Department of Orthodontics, Government Dental College, Calicut, Kerala, India

Department of Orthodontics, Government Dental College, Calicut, Kerala, India.

出版信息

Eur J Orthod. 2015 Aug;37(4):386-90. doi: 10.1093/ejo/cju065. Epub 2014 Oct 28.

Abstract

BACKGROUND

Relative position of the glenoid fossa would play a significant role in the morphology of lower face. The aim of the present study was to cephalometrically evaluate the position of the glenoid fossa in a group of unilateral cleft lip and palate (UCLP) patients in order to better clarify the role of this craniofacial component in skeletal disharmonies associated with this anomaly.

METHODS

Lateral cephalometric radiographs of 59 patients (32 males and 27 females) with surgically repaired UCLP (mean age 19.5±1.4 years) along with an equal number of age and gender matched skeletal Class I controls were analyzed for sagittal and vertical position of the glenoid fossa as well as lower anterior face height (LAFH), mandibular plane and length.

RESULTS

Paired samples t-test revealed a statistically significant anterior positioning of the glenoid fossa in UCLP subjects. A more cranial positioning of the glenoid fossa, basion, pterygomaxillary fissure, and posterior nasal spine were also seen to be associated with the cleft group on vertical evaluation. Effective length of mandible was normal with significantly steeper mandibular plane and increased LAFH.

LIMITATIONS

Further investigations using three dimensional imaging techniques is necessary for better clinical interpretation.

CONCLUSIONS

The glenoid fossa is positioned more cranially and anteriorly in UCLP individuals, clinically contributing to the mandibular prominence and concave facial profile inspite of their mandibular length being normal. Steep mandibular planes and increased LAFH reportedly associated with a cranially positioned glenoid fossa is observed in UCLP patients also.

摘要

背景

关节盂的相对位置在下颌面部形态中起着重要作用。本研究的目的是通过头影测量法评估一组单侧唇腭裂(UCLP)患者关节盂的位置,以便更好地阐明这个颅面组成部分在与该畸形相关的骨骼不协调中的作用。

方法

分析了59例接受手术修复的UCLP患者(32例男性和27例女性,平均年龄19.5±1.4岁)的侧位头影测量X线片,以及同等数量年龄和性别匹配的骨骼I类对照,以评估关节盂的矢状和垂直位置,以及下颌前面部高度(LAFH)、下颌平面和长度。

结果

配对样本t检验显示,UCLP受试者的关节盂在统计学上有显著的向前移位。在垂直评估中,还发现关节盂、颅底点、翼上颌裂和后鼻棘的位置更高与腭裂组相关。下颌骨有效长度正常,但下颌平面明显更陡,LAFH增加。

局限性

需要使用三维成像技术进行进一步研究,以获得更好的临床解释。

结论

在UCLP个体中,关节盂的位置更高且更靠前,尽管下颌长度正常,但在临床上会导致下颌突出和面部轮廓凹陷。在UCLP患者中也观察到,据报道下颌平面陡峭和LAFH增加与关节盂位置较高有关。

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