弥合差距:单侧唇腭裂患者的蝶鞍

Bridging the Gap: Sella Turcica in Unilateral Cleft Lip and Palate Patients.

作者信息

Sundareswaran Shobha, Nipun C A

出版信息

Cleft Palate Craniofac J. 2015 Sep;52(5):597-604. doi: 10.1597/13-258.

Abstract

OBJECTIVES

The aims of this study were to analyze the prevalence of sella turcica bridging and to measure the size of the sella turcica on profile cephalograms in a homogenous group of surgically repaired unilateral cleft lip and palate (UCLP) patients.

SETTING

Tertiary care center.

DESIGN

Retrospective cross-sectional study.

PATIENTS

Preorthodontic lateral cephalometric radiographs of 64 UCLP individuals between the ages of 16 and 29 years along with an equal number of age- and sex-matched skeletal Class I controls.

MAIN OUTCOME MEASURES

The extent of calcification of the interclinoid ligament was quantified (completely calcified, partially calcified, no calcification) and mean values compared. Length, depth, and diameter of the sella turcica were also measured. The results were statistically analyzed using paired t test and Wilcoxon signed ranks test.

RESULTS

Complete sella bridging of both type A (4.6%) and type B (21.7%) was significantly higher in UCLP patients. This has not been reported previously. Partial sella bridging was also higher in cleft patients as evaluated by two methods (42.18%, 39.06%). This study demonstrated a statistically significant decrease in all dimensions of sella turcica in UCLP patients.

CONCLUSIONS

The UCLP patients apparently had higher predilection for sella turcica bridging. The dimensions of sella turcica were also seen to be significantly smaller than the control group. Defective proliferation and deviated pathways of neural crest cell migration as well as premature rupture of contact between neuroepithelium and oral ectoderm as postulated causes are discussed.

摘要

目的

本研究旨在分析一组同质的手术修复单侧唇腭裂(UCLP)患者蝶鞍桥接的患病率,并在侧位头影测量片上测量蝶鞍的大小。

设置

三级医疗中心。

设计

回顾性横断面研究。

患者

64例年龄在16至29岁之间的UCLP个体的正畸前侧位头影测量X线片,以及同等数量年龄和性别匹配的骨骼I类对照。

主要观察指标

量化鞍间韧带的钙化程度(完全钙化、部分钙化、无钙化)并比较平均值。还测量了蝶鞍的长度、深度和直径。结果采用配对t检验和Wilcoxon符号秩检验进行统计学分析。

结果

UCLP患者中A 型(4.6%)和B型(21.7%)的完全蝶鞍桥接明显更高。此前未见报道。通过两种方法评估,腭裂患者的部分蝶鞍桥接也更高(42.18%,39.06%)。本研究表明,UCLP患者蝶鞍的所有维度在统计学上均显著减小。

结论

UCLP患者显然对蝶鞍桥接有更高的倾向。蝶鞍的尺寸也明显小于对照组。讨论了神经嵴细胞迁移的增殖缺陷和途径偏差以及神经上皮与口腔外胚层之间接触过早破裂等假定原因。

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