Division of Plastic Surgery, Western University, London, ON, Canada.
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Cleft Palate Craniofac J. 2023 Nov;60(11):1359-1365. doi: 10.1177/10556656221106891. Epub 2022 Jun 13.
Pre-surgical orthopedic (PSO) devices can be used in the management of patient with cleft lip/palate (CL/P) to narrow the alveolar gap (AG) prior to lip surgery. There are few studies comparing these 2 devices. The objective of this work was to compare the effects of active and passive PSO devices on facial growth in a single surgeon's cohort of patients with CL/P over a 10-year period.
A retrospective review of all patients with CL/P in a single surgeon's practice from 2002 to 2018 was performed. Preoperative measurements of AG size were done using electronic calipers on patient molds. Patient radiographs were taken at 5 and 10 years of age and cephalometric landmarks were plotted using specialized software. Independent sample -tests were used to compare means for maxillary, mandibular, vertical, and dento-alveolar growth parameters.
Twenty patients with an active device and 23 patients with a passive device were included. No differences were observed in the basic demographic information between the two groups. At the time of lip repair, patients with a passive device had significantly larger horizontal AGs ( < .01), but by the time of palate repair, there was no difference between the two groups ( = .94). There was no significant difference in any growth measurements between the active and passive device groups at 5 and 10 years.
Despite closing the AG more quickly, patients treated with an active device have no significant difference in facial growth at 10 years compared to patients treated with a passive device.
术前矫形（PSO）装置可用于唇裂/腭裂（CL/P）患者的治疗，以在唇裂修复术前缩小牙槽裂隙（AG）。目前，比较这两种装置的研究较少。本研究旨在比较在 10 年期间，同一位外科医生治疗的 CL/P 患者中，主动式和被动式 PSO 装置对面部生长的影响。
对 2002 年至 2018 年期间同一位外科医生治疗的所有 CL/P 患者进行回顾性研究。在患者模型上使用电子卡尺对 AG 大小进行术前测量。在 5 岁和 10 岁时拍摄患者的射线照片，并使用专门的软件描绘头影测量标志点。使用独立样本 t 检验比较上颌、下颌、垂直和牙牙槽生长参数的均值。
纳入了 20 名使用主动式装置的患者和 23 名使用被动式装置的患者。两组患者的基本人口统计学信息无差异。在唇裂修复时，使用被动式装置的患者的横向 AG 明显更大（<0.01），但在腭裂修复时，两组之间无差异（=0.94）。在 5 岁和 10 岁时，主动式和被动式装置组之间的任何生长测量均无显著差异。
尽管主动式装置能更快地关闭 AG，但与使用被动式装置的患者相比，使用主动式装置的患者在 10 岁时的面部生长并无显著差异。
