Mbuyi-Musanzayi S, Tshilombo Katombe F, Lukusa Tshilobo P, Kalenga Mwenze Kayamba P, Devriendt K, Reychler H
Department of Surgery, Paediatric and Maxillofacial Surgery, University Clinic of Lubumbashi, University of Lubumbashi, Lubumbashi, Congo.
Genetics Department, University Clinic of Kinshasa, University of Kinshasa, Kinshasa, Congo.
Int J Oral Maxillofac Surg. 2017 Oct;46(10):1338-1345. doi: 10.1016/j.ijom.2017.05.022. Epub 2017 Jun 16.
One hundred and one patients with complete or incomplete cleft lip underwent the anatomical subunit approximation technique for repair. The patients were followed up prospectively for 1year. The objective of this study was to determine the outcomes for the nasolabial area through anthropometric measurements and assessment of the Asher-McDade Aesthetic Index and Steffensen's criteria at 1year after surgery. Six assessors (three cleft surgeons and three non-surgeon medical professionals) examined cropped images; reliability was assessed using Cronbach's alpha. The difference in lip length between the healthy and operated sides was 0.61mm and the difference in nostril diameter was 0.37mm (differences not significant). The average scar width was 2.78±1.35mm. Hypertrophic scars were observed in 9.9% of cases. The average Asher-McDade Aesthetic Index rating varied between 1.35 and 1.98 for all parameters. Cronbach's alpha coefficient was 0.83, 0.89, 0.98, and 0.89 for nasal form, nasal symmetry, vermilion border, and nasolabial profile, respectively. Steffensen's criteria rated appearance as 'good' in 69.3% to 91.1% of cases. The anatomical subunit approximation technique can be performed in Sub-Saharan Africans for all types of unilateral cleft lip. It significantly improves the length of the medial and lateral lips, leaving an acceptable scar. A study with a larger sample size and longer follow-up is warranted.
101例唇裂完全或不完全的患者接受了解剖亚单位近似技术修复。对患者进行了为期1年的前瞻性随访。本研究的目的是通过人体测量以及在术后1年评估阿舍 - 麦克达德美学指数和斯特芬森标准，来确定鼻唇区域的治疗效果。六名评估者（三名唇裂外科医生和三名非外科医学专业人员）检查裁剪后的图像；使用克朗巴哈系数评估可靠性。健康侧与手术侧的唇长差异为0.61毫米，鼻孔直径差异为0.37毫米（差异不显著）。平均瘢痕宽度为2.78±1.35毫米。9.9%的病例观察到增生性瘢痕。所有参数的阿舍 - 麦克达德美学指数平均评分在1.35至1.98之间。鼻形、鼻对称性、唇红缘和鼻唇轮廓的克朗巴哈系数分别为0.83、0.89、0.98和0.89。斯特芬森标准在69.3%至91.1%的病例中将外观评为“良好”。解剖亚单位近似技术可用于撒哈拉以南非洲人所有类型的单侧唇裂修复。它能显著改善内侧和外侧唇的长度，留下可接受的瘢痕。有必要进行一项样本量更大、随访时间更长的研究。
