Peterson Petra, Parikakis Konstantinos, Karsten Agneta
Department of Molecular Medicine and Surgery, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
Department of Plastic Surgery and Craniofacial Surgery, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
Eur J Orthod. 2025 Feb 7;47(2). doi: 10.1093/ejo/cjae066.
To compare cephalometric long-term outcomes in patients with unilateral cleft lip and palate (UCLP) and treated with three different surgical protocols for palatal repair. Furthermore, to investigate growth longitudinally and evaluate the possibility to predict the outcome at age 19 from cephalometric values at 5 years.
MATERIALS/METHODS: Lateral cephalograms of 68 patients, operated according to the Veau-Wardill-Kilner technique (n = 13), the minimal incision technique (n = 39), or MIT with muscle reconstruction (MITmr) (n = 16) were assessed. At a mean age of 19.0 (SD 0.7) years, 17 skeletal and 6 soft tissue variables were analysed using analysis of variance (ANOVA) with pairwise comparison. Lateral cephalograms at a mean age of 5.1 (SD 0.4) years, from 32 of the 68 patients were used to predict values at 19 years, using a multiple linear regression.
There were statistically significant differences between the three surgical techniques for eight of the skeletal variables and for two of the soft-tissue variables at 19 years. The angle between the sella/nasion plane and the nasion/A plane (SNA) was 74.5 (SD 3.8) after Veau-Wardill-Kilner (VWK), 77.6 (SD 5.3) after minimal incision technique (MIT), and 76.7 (SD 2.6) after MITmr. Adjusted for baseline values, at 5 years, only face height had a significant effect dependent on surgical technique.
Due to the exclusion criteria or missing medical records, only 43% of 157 consecutive patients could be included in the study.
MIT and MITmr resulted in better cephalometric results regarding facial growth sagittally and vertically compared to VWK. Most of the cephalometric variables measured showed a strong positive relation between the value at 5 and the value at 19 years of age.
比较采用三种不同腭裂修复手术方案治疗的单侧唇腭裂（UCLP）患者的头影测量长期结果。此外，纵向研究生长情况，并评估根据5岁时的头影测量值预测19岁时结果的可能性。
材料/方法：对68例患者的头颅侧位片进行评估，这些患者分别按照Veau-Wardill-Kilner技术（n = 13）、最小切口技术（n = 39）或带肌肉重建的最小切口技术（MITmr）（n = 16）进行手术。在平均年龄19.0（标准差0.7）岁时，使用方差分析（ANOVA）及两两比较对17个骨骼变量和6个软组织变量进行分析。在68例患者中的32例平均年龄5.1（标准差0.4）岁时的头颅侧位片，用于通过多元线性回归预测19岁时的值。
在19岁时，三种手术技术在8个骨骼变量和2个软组织变量方面存在统计学显著差异。Veau-Wardill-Kilner（VWK）术后蝶鞍/鼻根平面与鼻根/A平面（SNA）之间的角度为74.5（标准差3.8），最小切口技术（MIT）术后为77.6（标准差5.3），MITmr术后为76.7（标准差2.6）。根据5岁时的基线值进行调整后，只有面部高度受手术技术的影响具有显著意义。
由于排除标准或病历缺失，157例连续患者中只有43%可纳入本研究。
与VWK相比，MIT和MITmr在面部矢状向和垂直向生长的头影测量结果方面更好。所测量的大多数头影测量变量在5岁时的值与19岁时的值之间呈现出很强的正相关关系。
