Laverde Bruno Leonardo Bancke, da Silva Freitas Renato, Nasser Isis Juliane Guarezi
*Federal University of Parana †Plastic Surgery Unit, Department of Surgery, School of Medicine, Federal University of Parana (UFPR) ‡Assistance Center for Cleft Lip and Palate (CAIF), Curitiba, Brazil.
J Craniofac Surg. 2016 Jan;27(1):78-81. doi: 10.1097/SCS.0000000000002265.
Unilateral cleft lip (UCL) patients have lip and nose deformities that must be addressed during lip repair. Currently, devices to achieve lip and nose improvements have been developed. The most researched presurgical molding device is the nasoalveolar molding (NAM), which has shown favorable results. However, clinical observation shows that unilateral cleft patients, even without molding devices, achieve spontaneous improvements. The aim of this study is to compare morphological and symmetry changes in nose and lip, between patients less than 30-day old and those submitted to cheiloplasty, at 6 months of age.
A total of 27 UCL patients with 2 photographs were selected. The pictures were taken from frontal view and nasal base view at 2 distinct moments: before 30 days of life (t1) and at 6 months of age, during cheiloplasty surgery (T2). Images were analyzed with indirect measurement to assess lip and nose dimensions and nasal symmetry. ImageJ software was used to perform the analyses.
A total of 20 patients (P < 0.05) had an average cleft width reduction of 15% [standard deviation (SD) ± 11%]. A 55% average increase (SD ± 29%) was observed in nostril height of cleft side in 16 of patients (P < 0.05). There was an reduction in facial asymmetry of nostril width (P < 0.05), from 95% (SD ± 90%) (t1) to 59% (SD ± 50) (T2). Also, nasal base width asymmetry (P < 0.05) was decreased from 64% (SD ± 66%) (t1) to 40% (SD ± 29%) (T2).
Facial growth causes a natural improvement on cleft morphological changes and nasal symmetry.
单侧唇裂（UCL）患者存在唇鼻畸形，在唇修复过程中必须加以解决。目前，已开发出用于改善唇鼻的装置。研究最多的术前塑形装置是鼻牙槽塑形（NAM），其已显示出良好效果。然而，临床观察表明，即使没有塑形装置，单侧唇裂患者也会实现自发改善。本研究的目的是比较30日龄以下患者与6月龄接受唇裂修复术患者的鼻唇形态及对称性变化。
共选取27例UCL患者，有两张照片。照片在两个不同时间从正面和鼻底视图拍摄：出生30天前（t1）和6月龄唇裂修复手术期间（T2）。通过间接测量分析图像以评估唇鼻尺寸和鼻对称性。使用ImageJ软件进行分析。
共有20例患者（P < 0.05）平均裂隙宽度减少15% [标准差（SD）± 11%]。16例患者（P < 0.05）患侧鼻孔高度平均增加55%（SD ± 29%）。鼻孔宽度面部不对称性降低（P < 0.05），从95%（SD ± 90%）（t1）降至59%（SD ± 50）（T2）。此外，鼻底宽度不对称性（P < 0.05）从64%（SD ± 66%）（t1）降至40%（SD ± 29%）（T2）。
面部生长使唇裂形态变化和鼻对称性自然改善。
