Ozawa Terumi Okada, Reis Luciana Lais Savero, Kato Renata Mayumi, Rocha Diógenes Laercio, Sathler Renata, Garib Daniela Gamba
1 Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil.
2 Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, São Paulo, Brazil.
Cleft Palate Craniofac J. 2018 Oct;55(9):1211-1217. doi: 10.1177/1055665618767418. Epub 2018 Apr 13.
To evaluate the aesthetics of nasolabial appearance and facial profile of children with unilateral cleft lip and palate (UCLP) submitted to 2-stage palate repair with vomerine flap.
Retrospective.
Single center.
Forty patients with UCLP, mean age of 7.81 years of both sexes, rehabilitated at a single center by 1 plastic surgeon.
Lip and anterior palate repair with nasal alar repositioning was performed at 3 to 6 months of age by Millard technique and vomer flap, respectively. Posterior palate was repaired at 18 months by Von Langenbeck technique.
MAIN OUTCOME MEASURE(S): Four cropped digital facial photographs of each patient were evaluated by 3 orthodontists to score the nasolabial aesthetics and profile. Frequencies of each score as well means and medians were calculated. Kappa test was used for evaluating inter- and intrarater reproducibility.
The nasal form and deviation was scored as good/very good in 70%, fair in 22.5%, and poor in 7.5% of the sample. The nasal-subnasal aesthetic was considered good/very good in 55%, fair in 30%, and poor in 15% of the sample. The lip vermilion border and the white part of surgical scar aesthetics were good/very good in 77.5% and 80%, fair in 17.5% for both categories, and poor in 5% and 2.5% of the cases, respectively. In all, 67.5% showed convex facial profile, 20% was straight, and 12.5% was concave profile.
Two-stage palatoplasty presented an adequate aesthetical results for the majority of patients with UCLP in the mixed dentition.
评估采用犁骨瓣进行两阶段腭裂修复的单侧唇腭裂（UCLP）患儿的鼻唇外观和面部轮廓的美学效果。
回顾性研究。
单一中心。
40例UCLP患者，男女平均年龄7.81岁，由1名整形外科医生在单一中心进行修复。
分别在3至6个月大时采用Millard技术和犁骨瓣进行唇和前腭裂修复及鼻翼复位。18个月时采用Von Langenbeck技术修复后腭裂。
3名正畸医生对每位患者的4张裁剪后的面部数码照片进行评估，以对鼻唇美学和轮廓进行评分。计算每个评分的频率以及均值和中位数。采用Kappa检验评估评估者间和评估者内的可重复性。
样本中，70%的鼻形和偏差评分为良好/非常好，22.5%为中等，7.5%为差。55%的样本鼻-鼻下美学被认为良好/非常好，30%为中等，15%为差。唇红缘和手术瘢痕白色部分美学分别有77.5%和80%为良好/非常好，两类均有17.5%为中等，5%和2.5%的病例为差。总体而言，67.5%表现为凸面型，20%为直面型，12.5%为凹面型。
两阶段腭裂修复术对大多数混合牙列期的UCLP患者呈现出足够的美学效果。
