Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Unidade de Estudos do Sono, Laboratório de Fisiologia, Bauru, SP, Brasil.
Universidade de São Paulo, Hospital de Reabilitação de Anomalias Craniofaciais, Seção de Otorrinolaringologia, Bauru, SP, Brasil.
J Appl Oral Sci. 2024 Nov 22;32:e20240212. doi: 10.1590/1678-7757-2024-0212. eCollection 2024.
Cleft lip and palate are the most common congenital malformations in the craniofacial region, occurring at a rate of 1:700 births in Brazil. These conditions lead to functional impacts on patients, such as changes in breathing, teeth, speech, chewing, swallowing and sucking. Treatment begins with primary surgeries, including lip and palate repair, which aim to reconstruct the soft tissues. Secondary alveolar bone grafting (SABG) reconstructs the bone defect in the cleft region, with the main goal of supplying bone tissue to the cleft region and restore the continuity of the alveolar process. To measure the changes in cross-sectional areas (CSAs) and nasal volume in patients and their impact on the nasal cavity (NC) in the two-month postoperative period (PO2M).
This study included 15 patients with complete unilateral cleft lip and palate (U/CLP) indicated for alveolar bone grafting (ABG). Cone beam computed tomography scans obtained prior to SABG and at PO2M were compared. Nasal volumes and CSAs were measured by marking the masks delimiting the nasal cavity on CT scans using Mimics™ software.
NC volumes (total, right and left sides) were statistically lower at PO2M in patients with left-sided UCLP. In right-sided UCLP, these volumes were only significant for the total NC and left NC. The CSAs of the internal nasal valve in both groups showed significantly lower values compared to the preoperative period (p≤0.05).
In the short term, alveolar bone graft surgery reduces the volume of nasal cavities and the cross-sectional areas of the right and left internal nasal valve as a whole, not only the cleft area where the graft material was placed.
唇腭裂是颅面区域最常见的先天性畸形,在巴西的发生率为每 700 例出生一例。这些情况会对患者的功能产生影响,例如呼吸、牙齿、言语、咀嚼、吞咽和吸吮功能的改变。治疗始于初级手术,包括唇腭裂修复,旨在重建软组织。二次牙槽骨移植(SABG)重建裂隙区域的骨缺损,主要目标是为裂隙区域提供骨组织,并恢复牙槽突的连续性。为了测量术后两个月(PO2M)患者的横截面积(CSA)和鼻腔体积的变化及其对鼻腔(NC)的影响。
本研究纳入了 15 例单侧完全唇腭裂(U/CLP)患者,这些患者均需要进行牙槽骨移植(ABG)。比较 SABG 术前和 PO2M 时的锥形束 CT 扫描。通过在 CT 扫描上标记界定鼻腔的蒙版,使用 Mimics™软件测量鼻腔体积和 CSA。
在左侧 UCLP 患者中,NC 体积(总、右、左侧)在 PO2M 时统计学上降低。在右侧 UCLP 中,这些体积仅对总 NC 和左侧 NC 有显著影响。两组的内鼻阀 CSA 值与术前相比均显著降低(p≤0.05)。
在短期内,牙槽骨移植手术会减少鼻腔的体积和整个右侧和左侧内鼻阀的 CSA,而不仅仅是移植材料放置的裂隙区域。