利用人体测量评估对单侧唇裂和鼻翼进行二期重建的两种手术技术的治疗效果：一项随机对照试验
Treatment outcomes of two surgical techniques in secondary reconstruction of unilateral cleft lip and ala nasi utilizing anthropometry assessment: a randomized controlled trial.
作者信息
Humadi Ebrahim, Karkoutly Mawia, Beit Zafin Kara
机构信息
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic.
出版信息
Maxillofac Plast Reconstr Surg. 2025 Jan 2;47(1):1. doi: 10.1186/s40902-024-00456-3.
BACKGROUND
An orofacial cleft significantly impacts the oral health-related quality of life of children and teenagers. Secondary reconstruction is a more complex procedure due to tissue deficiency and scarring. The study aimed to evaluate the use of Pfeifer's wave-line incision method and the rotational flap method in the secondary reconstruction of unilateral lip clefts in patients with unilateral cleft lip and ala nasi aged 5-25 years utilizing anthropometry assessment.
METHODS
It was a double-blinded, randomized, parallel-group, active-controlled trial with two arms. Twenty-four patients were randomly divided into two groups. Group 1: Rotational flap method. Group 2: Control group, Pfeifer's wave-line incision method. The following anthropometric measurements were considered: Lb(X):En-En: The horizontal position of the center of the cupid's bow. Ch-Lt(l:r): The distance between the cheilion and the tip of the cupid's bow. Lt-Lb(l:r): The length of the cupid's bow. Lt(Y)(l:r): The size of the upper lip. Lt-Lt'(l:r): The height of the vermilion at the tip of the cupid's bow. Photographs were performed according to the follow-up periods: At the baseline and before surgery (t). Immediately after surgery (t). Two weeks after surgery (t). Six months after surgery (t).
RESULTS
The rotational flap method did not outperform Pfeifer's method in the studied anthropometric measurements. In the rotational flap method group, there was a significant improvement in the mean value of Ch-Lt(l:r) from t (1.156 ± 0.206) to t (0.962 ± 0.098), and in the average value of Lt(Y)(l:r) from t (0.944 ± 0.023) to t (0.990 ± 0.011) (p < 0.05). In Pfeifer's method group, the mean value of Ch-Lt(l:r) was (1.141 ± 0.158) at t, and then improved to become (1.007 ± 0.084) at t (p < 0.05), the average value of Ch-Lt(l:r) at t was (0.942 ± 0.026), which improved to (0.991 ± 0.012) at t, and the average value of Lt-Lt'(l:r) increased from t (1.308 ± 1.174) to t (1.050 ± 0.054) (p < 0.05).
CONCLUSION
Pfeifer's wave-line incision and rotational flap methods achieve similar aesthetic results in the appearance of the lip or Cupid's bow after a 6-month follow-up.
TRIAL REGISTRATION
ISRCTN registry, ISRCTN36320776, registered 06 November 2024.
背景
口腔颌面部裂隙会显著影响儿童和青少年与口腔健康相关的生活质量。由于组织缺损和瘢痕形成，二期重建是一个更为复杂的手术。本研究旨在利用人体测量学评估，评价Pfeifer波浪线切口法和旋转皮瓣法在5至25岁单侧唇裂合并鼻翼裂患者单侧唇裂二期重建中的应用。
方法
这是一项双臂双盲、随机、平行组、活性对照试验。24例患者被随机分为两组。第1组：旋转皮瓣法。第2组：对照组，Pfeifer波浪线切口法。考虑以下人体测量指标：Lb(X):En-En：唇弓中央的水平位置。Ch-Lt(l:r)：口角与唇弓尖之间的距离。Lt-Lb(l:r)：唇弓的长度。Lt(Y)(l:r)：上唇的大小。Lt-Lt'(l:r)：唇弓尖处唇红的高度。根据随访期进行拍照：基线时和手术前（t）。手术后即刻（t）。手术后两周（t）。手术后六个月（t）。
结果
在研究的人体测量指标中，旋转皮瓣法并不优于Pfeifer法。在旋转皮瓣法组中，Ch-Lt(l:r)的平均值从t时的(1.156±0.206)显著改善至t时的(0.962±0.098)，Lt(Y)(l:r)的平均值从t时的(0.944±0.023)改善至t时的(0.990±0.011)（p<0.05）。在Pfeifer法组中，Ch-Lt(l:r)在t时的平均值为(1.141±0.158)，然后在t时改善为(1.007±0.084)（p<0.05），Ch-Lt(l:r)在t时的平均值为(0.942±0.026)，在t时改善为(0.991±0.012)，Lt-Lt'(l:r)的平均值从t时的(1.308±1.174)增加至t时的(1.050±0.054)（p<0.05）。
结论
经过6个月的随访，Pfeifer波浪线切口法和旋转皮瓣法在唇部或唇弓外观上取得了相似的美学效果。
试验注册
ISRCTN注册库，ISRCTN36320776，于2024年11月6日注册。
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