Lux Sonja, Mayr Matthias, Schwaiger Michael, Edmondson Sarah-Jayne, Steiner Christoph, Schachner Peter, Gaggl Alexander
Department of Oral and Maxillofacial Surgery, University Clinic Salzburg, 5020 Salzburg, Austria.
Department of Oral and Maxillofacial Surgery, Medical University of Graz, 8036 Graz, Austria.
J Clin Med. 2022 May 23;11(10):2943. doi: 10.3390/jcm11102943.
Different surgical techniques are available to adequately correct the primary cleft lip deformity; however, when compared, none of these techniques have proven superior with regard to achieving optimal aesthetic results. Thus, the aim of this retrospective study was to assess the nasolabial appearance in patients with unilateral cleft lip and palate (UCLP) at age five with reference to two techniques for primary cleft lip repair used in our service: Pfeifer's wave-line procedure and Randall's technique. A modified Asher-McDade Aesthetic Index was applied to appraise the nasolabial area by means of 2D photographs of non-syndromic five-year-old patients with a UCLP. In this context, three parameters were assessed: 1. nasal frontal view; 2. shape of the vermilion border and philtrum length; and 3. the nasolabial profile. Five professionals experienced in cleft care were asked to rate the photographs on two occasions. Overall, 53 patients were included in the final analysis, 28 of whom underwent lip repair according to Pfeifer; 25 were treated employing Randall's technique. Statistically significant differences between the two techniques regarding philtrum length and vermilion border were found ( = 0.046). With reference to the other parameters assessed, no significant differences were determined. The results suggest that Randall's cleft lip repair may allow for more accurate alignment of the vermilion border and more adequate correction of the cleft lip length discrepancy in comparison to Pfeifer's wave-line technique.
有多种不同的外科技术可用于充分矫正原发性唇裂畸形；然而，经比较，这些技术在实现最佳美学效果方面均未被证明具有优越性。因此，这项回顾性研究的目的是参照我们科室使用的两种原发性唇裂修复技术：Pfeifer波浪线手术和Randall技术，评估单侧唇腭裂（UCLP）患者5岁时的鼻唇外观。采用改良的Asher-McDade美学指数，通过非综合征性5岁UCLP患者的二维照片来评估鼻唇区域。在此背景下，评估了三个参数：1. 鼻正面观；2. 唇红缘形状和人中长度；3. 鼻唇侧面观。邀请了五名在唇腭裂护理方面经验丰富的专业人员对照片进行两次评分。总体而言，53例患者纳入最终分析，其中28例根据Pfeifer技术进行唇裂修复；25例采用Randall技术治疗。发现两种技术在人中长度和唇红缘方面存在统计学显著差异（P = 0.046）。关于评估的其他参数，未确定显著差异。结果表明，与Pfeifer波浪线技术相比，Randall唇裂修复术可能使唇红缘对齐更准确，唇裂长度差异矫正更充分。
