Mancini Laura, Avinoam Shayna, Grayson Barry H, Flores Roberto L, Staffenberg David A, Shetye Pradip R
Hansjorg Wyss Department of Plastic Surgery, 12297New York University Langone Health, New York, NY, USA.
Cleft Palate Craniofac J. 2022 Apr;59(4):475-483. doi: 10.1177/10556656211012858. Epub 2021 May 25.
Utilize 3-dimensional (3D) photography to evaluate the nasolabial changes in infants with bilateral cleft lip and palate (BCLP) who underwent nasoalveolar molding (NAM) and primary reconstructive surgery.
This is a retrospective serial longitudinal study of consecutively enrolled infants from September 2012 to July 2016 with BCLP who underwent NAM before primary lip and nose reconstructive surgery. It included infants who had digital 3dMD stereophotogrammetry records at initial presentation (T1), completion of NAM (T2), and 3 weeks following primary repair (T3). Twelve infants fulfilled the inclusion criteria. 3dMD Vultus software was used to orient images and plot 16 nasolabial points with , , coordinates to obtain the linear and angular measurements. Nasal form changes were measured and analyzed between T1 (0.5 months old), T2 (5 months old), and T3 (6 months old). Intraclass correlation coefficient was performed for intrarater reliability. Averaged data from the 3D images was statistically analyzed from T1 to T2 and T2 to T3 with Wilcoxon tests. Unaffected infant norms from the Farkas publication were used as a control sample.
After NAM therapy, statistically significant changes in the position of subnasale and labius superius improved nasolabial symmetry. Both retruded after NAM were displaced downward after NAM and surgical correction with respect to soft tissue nasion. The nasal tip's projection was maintained with NAM and surgical correction. The columella lengthened from 1.4 to 4.71 mm following NAM.
There was a significant improvement in the nasolabial anatomy after NAM, and this was further enhanced after primary reconstructive surgery.
利用三维（3D）摄影技术评估双侧唇腭裂（BCLP）婴儿在接受鼻牙槽塑形（NAM）和一期重建手术后鼻唇结构的变化。
这是一项回顾性系列纵向研究，对2012年9月至2016年7月连续纳入的患有BCLP且在一期唇鼻重建手术前行NAM的婴儿进行研究。研究包括在初次就诊时（T1）、NAM完成时（T2）以及一期修复后3周（T3）有数字化3dMD立体摄影测量记录的婴儿。12名婴儿符合纳入标准。使用3dMD Vultus软件对图像进行定位，并绘制16个鼻唇点的x、y、z坐标，以获得线性和角度测量值。测量并分析T1（0.5个月大）、T2（5个月大）和T3（6个月大）之间鼻形的变化。进行组内相关系数分析以评估评分者内部的可靠性。使用Farkas出版物中的正常未受影响婴儿数据作为对照样本。从T1到T2以及从T2到T3，对3D图像的平均数据进行Wilcoxon检验的统计学分析。
经过NAM治疗后，鼻下点和上唇位置的统计学显著变化改善了鼻唇对称性。NAM后后缩的两者在NAM及手术矫正后相对于软组织鼻根点向下移位。鼻尖的突出度在NAM及手术矫正后得以维持。NAM后鼻小柱从1.4毫米延长至4.71毫米。
NAM后鼻唇解剖结构有显著改善，一期重建手术后进一步增强。
