Murthy Jyotsna, Manisha Devi
Department of Plastic Srugery, Sri Ramachandra University, Chennai, India.
Cleft and Craniofacial Center, Sri Ramachandra University, Chennai, India.
Indian J Plast Surg. 2016 Sep-Dec;49(3):336-339. doi: 10.4103/0970-0358.197247.
Pre-maxillary complex (pre-maxilla [PMX] + vomer) morphology in bilateral complete cleft of primary and secondary palate (BCLCP) is very complex and less reviewed in literature.
In this retrospective cross-sectional study, 200 consecutive BCLCP patients were selected. Their pre-operative clinical photographs and dental casts were evaluated by a single investigator at two different points of time, to study the morphology of PMX and vomer with special emphasis on deviation of vomer and rotation of PMX.
It is found that in above 70% of patients, PMX and vomer both displaced or deviated towards left side in horizontal plane and PMX rotated anticlockwise at PMX vomerine suture (PVS). In 10% of cases, both PMX and vomer are displaced towards the right side, PMX rotated clockwise at PVS. In 11% of cases, vomer is displaced towards the left side, but PMX rotated clockwise at PVS. In 5% of cases, vomer is displaced towards the right side, but PMX rotated anticlockwise at PVS. Both PMX and vomer are in midline in 4% of cases.
Specific morphological deviation of vomer and PMX has been studied. We put forward the probable hypothesis to explain the deviation and rotation of PMX.
在原发性和继发性腭裂双侧完全性腭裂（BCLCP）中，上颌前部复合体（前颌骨[PMX]+犁骨）的形态非常复杂，而在文献中较少有相关综述。
在这项回顾性横断面研究中，选取了200例连续的BCLCP患者。由一名研究者在两个不同时间点对他们术前的临床照片和石膏模型进行评估，以研究PMX和犁骨的形态，特别强调犁骨的偏移和PMX的旋转。
发现超过70%的患者中，PMX和犁骨在水平面均向左移位或偏移，且PMX在犁骨-前颌骨缝（PVS）处逆时针旋转。在10%的病例中，PMX和犁骨均向右移位，PMX在PVS处顺时针旋转。在11%的病例中，犁骨向左移位，但PMX在PVS处顺时针旋转。在5%的病例中，犁骨向右移位，但PMX在PVS处逆时针旋转。在4%的病例中，PMX和犁骨均位于中线。
研究了犁骨和PMX的特定形态学偏差。我们提出了可能的假说来解释PMX的偏差和旋转。
