Kondra Katelyn, Stanton Eloise, Jimenez Christian, Ngo Kalvyn, Wlodarczyk Jordan, Jacob Laya, Munabi Naikhoba C O, Chen Kevin, Urata Mark M, Hammoudeh Jeffrey A
5150Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.
12223Division of Plastic and Reconstructive Surgery, Keck School of Medicine, Los Angeles, CA, USA.
Cleft Palate Craniofac J. 2023 Mar;60(3):306-312. doi: 10.1177/10556656211062042. Epub 2021 Dec 6.
This study compares patients undergoing early cleft lip repair (ECLR) (<3-months) and traditional lip repair (TLR) (3-6 months) with/without nasoalveolar molding (NAM) to evaluate the effects of surgical timing on weight gain in hopes of guiding future treatment paradigms.
Retrospective review.
Children's Hospital of Los Angeles, California.
PATIENT, PARTICIPANTS: A retrospective chart review evaluated patients who underwent ECLR or TLR ± NAM from November 2009 through January 2020.
No intervention was performed.
MAIN OUTCOME MEASURE(S): Patient demographics, birth and medical history, perioperative variables, and complications were collected. Infant weights and age-based percentiles were recorded at birth, surgery, 8-weeks, 6-months, 12-months, and 24-months postoperatively. The main outcomes were weight change and weight percentile amongst ECLR and TLR ± NAM groups.
107 patients met inclusion criteria: ECLR, = 51 (47.6%); TLR + NAM, = 35 (32.7%); and TLR-NAM, = 21 (19.6%). ECLR patients had significantly greater changes in weight from surgery to 8-weeks and from surgery to 24-months postoperatively compared with both TLR ± NAM ( < .05). Age-matched weights in the ECLR group were significantly greater than TLR ± NAM at multiple time points postoperatively ( < .05).
ECLR significantly increased patient weights 24-months postoperatively when compared to TLR ± NAM. Specifically compared to TLR-NAM, ECLR weights were significantly greater at all time points past 6-months postoperatively. The results of this study demonstrate that ECLR can mitigate feeding difficulties and malnutrition traditionally seen in patients with cleft lip.
本研究比较接受早期唇裂修复术（ECLR）（<3个月）和传统唇裂修复术（TLR）（3 - 6个月）并接受或未接受鼻牙槽塑形（NAM）的患者，以评估手术时机对体重增加的影响，希望为未来的治疗模式提供指导。
回顾性研究。
加利福尼亚州洛杉矶儿童医院。
患者、参与者：一项回顾性病历审查评估了2009年11月至2020年1月期间接受ECLR或TLR ± NAM的患者。
未进行干预。
收集患者人口统计学资料、出生和病史、围手术期变量及并发症。记录婴儿出生时、手术时、术后8周、6个月、12个月和24个月时的体重及基于年龄的百分位数。主要观察指标为ECLR组和TLR ± NAM组的体重变化及体重百分位数。
107例患者符合纳入标准：ECLR组51例（47.6%）；TLR + NAM组35例（32.7%）；TLR - NAM组21例（19.6%）。与TLR ± NAM组相比，ECLR组患者术后从手术到8周以及从手术到24个月时体重变化显著更大（P <.05）。术后多个时间点，ECLR组年龄匹配的体重显著高于TLR ± NAM组（P <.05）。
与TLR ± NAM相比，ECLR术后24个月显著增加了患者体重。具体而言，与TLR - NAM相比，ECLR组术后6个月后的所有时间点体重均显著更高。本研究结果表明，ECLR可减轻传统上唇裂患者出现的喂养困难和营养不良。
