Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland; Department of Clinical Research, University of Basel, Spitalstrasse 12, 4031 Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167b, 4123 Allschwil, Switzerland.
Maxillofacial Department, Clinic of Pediatric Surgery, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw, Poland.
J Plast Reconstr Aesthet Surg. 2024 May;92:198-206. doi: 10.1016/j.bjps.2024.03.001. Epub 2024 Mar 7.
Presurgical plate therapy has been widely accepted as a treatment prior to palatal cleft closure. The effects of passive presurgical plate therapy on cleft morphology prior to single-stage unilateral cleft lip and palate (UCLP) repair were quantified.
We compared the dimensions of cleft width and cleft area (true cleft and palatal cleft) measured preoperatively at 2 European cleft centers. Center A performed single-stage UCLP repair in 8-month-old infants without any presurgical orthopedic treatment. Center B initiated passive presurgical plate therapy immediately after the birth of the neonates, followed by single-stage UCLP repair at 8 months of age.
We included 28 patients with complete UCLP from Center A and 12 patients from Center B. The average anterior width of the true cleft before surgery was significantly smaller in infants at Center B than that in Center A (p = 0.001) with 95% confidence interval of (1.8, 5.7) mm, but the average posterior width was similar in the 2 groups. The mean presurgical true cleft area amounted to 106.8 mm (SD = 42.4 mm) at Center A and 71.9 mm (SD = 32.2 mm) at Center B, with a confidence interval for the difference being (9.8, 60.1) mm. This corresponded to a 32.7% reduction of the true cleft area when passive presurgical plate therapy was used for the first 8 months of the infants' life.
Passive presurgical plate therapy in UCLP significantly reduced the cleft area. Implications for the subsequent surgical outcome might depend on the surgical technique used.
术前板治疗已被广泛接受，作为腭裂关闭前的一种治疗方法。本文定量研究了被动术前板治疗对单侧完全性腭裂（UCLP）一期修复术前腭裂形态的影响。
我们比较了欧洲 2 个腭裂中心术前测量的腭裂宽度和腭裂面积（真性腭裂和腭部腭裂）的差异。中心 A 在 8 月龄婴儿中进行无术前矫形治疗的单侧唇腭裂一期修复。中心 B 对新生儿立即开始被动术前板治疗，然后在 8 月龄时进行单侧唇腭裂一期修复。
我们纳入了中心 A 的 28 例完全性 UCLP 患儿和中心 B 的 12 例患儿。术前中心 B 患儿真性腭裂的前宽明显小于中心 A（p=0.001），置信区间为（1.8，5.7）mm，但两组的后宽相似。中心 A 组术前真性腭裂的平均面积为 106.8 mm（SD=42.4 mm），中心 B 组为 71.9 mm（SD=32.2 mm），差异置信区间为（9.8，60.1）mm。这相当于在婴儿生命的前 8 个月使用被动术前板治疗时，真性腭裂面积减少了 32.7%。
UCLP 中的被动术前板治疗显著减小了腭裂面积。对后续手术结果的影响可能取决于所使用的手术技术。
