Kormi Eeva, Peltola Elina, Lusila Niilo, Heliövaara Arja, Leikola Junnu, Suojanen Juho
Päijät-Häme Joint Authority for Health and Wellbeing, Department of Oral and Maxillofacial Surgery, Päijät-Häme Central Hospital, 15850 Lahti, Finland.
HUS Diagnostic Center, Radiology, Helsinki University Hospital, 00029 Helsinki, Finland.
J Pers Med. 2023 Jun 29;13(7):1067. doi: 10.3390/jpm13071067.
Facial asymmetry is common in unilateral clefts. Since virtual surgical planning (VSP) is becoming more common and automated segmentation is utilized more often, the position and asymmetry of the orbits can affect the design outcome. The aim of this study is to evaluate whether non-syndromic unilateral cleft lip and palate (UCLP) patients requiring orthognathic surgery have asymmetry of the bony orbits. Retrospectively, we analyzed the preoperative cone-beam computed tomography (CBCT) or computed tomography (CT) data of UCLP ( = 15) patients scheduled for a Le Fort 1 ( = 10) or bimaxillary osteotomy ( = 5) with VSP at the Cleft Palate and Craniofacial Center, Helsinki University Hospital. The width, height, and depth of the bony orbit and the distance between the sella turcica and infraorbital canal were measured. A volumetric analysis of the orbits was also performed. The measurements were tested for distribution, and the cleft side and the contralateral side were compared statistically with a two-sided paired -test. To assess asymmetry in the non-cleft population, we performed the same measurements of skeletal class III patients undergoing orthognathic surgery at Päijät-Häme Central Hospital ( = 16). The volume of bony orbit was statistically significantly smaller ( = 0.014), the distance from the infraorbital canal to sella turcica was shorter ( = 0.019), and the anatomical location of the orbit was more medio-posterior on the cleft side than on the contralateral side. The non-cleft group showed no statistically significant asymmetry in any measurements. According to these preliminary results, UCLP patients undergoing orthognathic surgery show asymmetry of the bony orbit not seen in skeletal class III patients without a cleft. This should be considered in VSP for the correction of maxillary hypoplasia and facial asymmetry in patients with UCLP.
面部不对称在单侧唇腭裂中很常见。由于虚拟手术规划（VSP）越来越普遍，且自动分割的应用也越来越频繁，眼眶的位置和不对称性会影响设计结果。本研究的目的是评估需要正颌手术的非综合征性单侧唇腭裂（UCLP）患者是否存在骨性眼眶不对称。我们回顾性分析了赫尔辛基大学医院腭裂与颅面中心计划接受Le Fort 1型（n = 10）或双颌截骨术（n = 5）并采用VSP的UCLP患者（n = 15）的术前锥形束计算机断层扫描（CBCT）或计算机断层扫描（CT）数据。测量了骨性眼眶的宽度、高度和深度以及蝶鞍与眶下管之间的距离。还对眼眶进行了容积分析。对测量结果进行分布测试，并采用双侧配对t检验对腭裂侧和对侧进行统计学比较。为了评估非腭裂人群的不对称性，我们对在派亚特-海梅中心医院接受正颌手术的III类骨骼患者（n = 16）进行了相同的测量。腭裂侧的骨性眼眶容积在统计学上显著较小（P = 0.014），眶下管到蝶鞍的距离较短（P = 0.019），且眼眶的解剖位置比非腭裂侧更偏中后。非腭裂组在任何测量中均未显示出统计学上的显著不对称。根据这些初步结果，接受正颌手术的UCLP患者存在骨性眼眶不对称，而在无腭裂的III类骨骼患者中未观察到这种情况。在VSP中矫正UCLP患者的上颌骨发育不全和面部不对称时应考虑这一点。
