Maggiulli F, Hinton C, Simpson L, Gujral S, Hardwicke J, Slator R, Pigott R W, Su T L, Richard B
Department of Pediatric Plastic Surgery, Competence Centre for Cleft Lip and Palate CHU University Hospital Lapeyronie 371 Av. du Doyen Gaston Giraud, 34090 Montpellier, France.
West Midlands Cleft Lip and Palate Service, Birmingham Children's Hospital NHS Foundation Trust,, Steelhouse Lane, Birmingham, B4 6NH, UK.
JPRAS Open. 2022 Jun 17;33:145-154. doi: 10.1016/j.jpra.2022.05.012. eCollection 2022 Sep.
To compare the symmetry of the lip following Rotation-Advancement cleft lip repair by Millard and Pigott and to investigate the effect on the symmetry of cleft side and gender by using different surgical protocols. Symmetry following cleft surgery was compared to that of non-cleft children.
Retrospective study of photographs of children aged 5 years.
Three decades of post-operative photographs of children treated by Millard and Pigott.
Eighty-nine children treated by Millard, 87 by Pigott and 91 non-cleft children.
Photographs were assessed using the Symnose Computer program, a rapid semi-objective quantitative assessment of lip symmetry.
Asymmetry score for each surgeon, and non-cleft children.
There was no significant difference in the median lip % mismatch score of Millard, 36.65% and Pigott, 38.52%. Right-sided clefts showed better symmetry than left-sided clefts for Millard (p<.001). This was reversed for Pigott (P=.0121). There was a difference (P<.001) between the symmetry of the two cleft cohorts and the non-cleft children (asymmetry 19.9%), and between Millard's outcomes following different lip surgical protocols (P < .0001), but no difference between Pigott's outcomes using different palate surgical protocols (P = 0.59).
Cleft lip repair by Millard and Pigott resulted in similar lip asymmetry (37% and 39% symmetry mismatch, respectively). Lip surgical protocol and cleft side may affect lip asymmetry. Palate surgery did not affect lip asymmetry. Following cleft surgery, children were more asymmetric than non-cleft children.
比较采用米勒德法和皮戈特法进行旋转推进式唇裂修复术后唇部的对称性，并研究采用不同手术方案对患侧对称性及性别的影响。将唇裂修复术后的对称性与非唇裂儿童的对称性进行比较。
对5岁儿童照片进行回顾性研究。
收集了米勒德和皮戈特治疗的儿童术后三十年的照片。
89例接受米勒德法治疗的儿童、87例接受皮戈特法治疗的儿童以及91例非唇裂儿童。
使用Symnose计算机程序评估照片，该程序可对唇部对称性进行快速半客观定量评估。
每位外科医生及非唇裂儿童的不对称评分。
米勒德组（36.65%）和皮戈特组（38.52%）唇部错配百分比的中位数无显著差异。对于米勒德法，右侧唇裂的对称性优于左侧唇裂（p<0.001）。而对于皮戈特法，情况则相反（P=0.0121）。两组唇裂患儿与非唇裂儿童的对称性存在差异（P<0.001，非唇裂儿童不对称率为19.9%），米勒德法采用不同唇部手术方案后的结果也存在差异（P<0.0001），但皮戈特法采用不同腭裂手术方案后的结果无差异（P=0.59）。
米勒德法和皮戈特法进行唇裂修复术后导致的唇部不对称情况相似（对称性错配分别为37%和39%）。唇部手术方案和唇裂侧可能会影响唇部不对称。腭裂手术不影响唇部不对称。唇裂修复术后，儿童比非唇裂儿童的不对称情况更明显。
