Raposo-Amaral Cassio Eduardo, Denadai Rafael, Almeida Ricardo Ruiz Garcia de, Marques Frederico Figueiredo, Lee Marina De Martino, Raposo-Amaral Cesar Augusto
*Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas †School of Medicine, University of São Paulo (USP), São Paulo ‡Faculty of Medicine, State University of Campinas (UNICAMP), Campinas, Brazil.
J Craniofac Surg. 2017 Oct;28(7):1730-1736. doi: 10.1097/SCS.0000000000003875.
The early premaxillary setback and lip adhesion remains as a controversial maneuver in the treatment of bilateral cleft lip and palate patients. This study aimed to assess extent of preoperative deformity and lip outcomes during the first year after surgery in bilateral cleft patients who underwent premaxillary setback and lip adhesion and to compare to those with primary lip repair.
A retrospective observational study was conducted of 16 nonsyndromic consecutive bilateral complete cleft lip patients (with and without Simonart band), who underwent primary cleft lip repair. Patients were allocated in group 1 without premaxillary setback and group 2 with premaxillary setback and lip adhesion. Preoperative and postoperative linear measurements were used for intergroup and intragroup comparisons.
Cutaneous lip height of patients in group 2 significantly (P < 0.05) improved after combined premaxillary setback and lip adhesion and primary cleft lip repair. There were no significant (all P > 0.05) differences in intragroup 1 comparisons, and in intergroup comparisons.
Bilateral cleft patients with a protruded and deviated premaxilla over 10 mm discrepancy of the lateral maxillary achieved noninferior lip symmetry 1 year postoperatively compared with patients with less severe original deformity.
在双侧唇腭裂患者的治疗中，早期上颌前份后退术和唇粘连术仍是一种存在争议的术式。本研究旨在评估接受上颌前份后退术和唇粘连术的双侧唇腭裂患者术后第一年的术前畸形程度和唇部手术效果，并与一期唇修复患者进行比较。
对16例连续的非综合征性双侧完全性唇腭裂患者（有或无西蒙氏带）进行回顾性观察研究，这些患者均接受了一期唇裂修复术。患者被分为两组，第1组未行上颌前份后退术，第2组行上颌前份后退术和唇粘连术。术前和术后的线性测量用于组间和组内比较。
第2组患者在接受上颌前份后退术联合唇粘连术及一期唇裂修复术后，皮肤唇高有显著改善（P<0.05）。第1组组内比较及组间比较均无显著差异（所有P>0.05）。
与初始畸形较轻的患者相比，上颌前突且偏斜超过10mm的双侧唇腭裂患者在术后1年实现了非劣效的唇部对称性。
