新生儿完全性唇腭裂术前鼻撑和正畸治疗的临床观察

A clinical study of presurgical nasoalveolar molding in infants with complete cleft lip and palate

目的观察新生儿完全性唇腭裂术前鼻撑和正畸治疗的效果.方法对 38 例完全性唇腭裂,通过模型测量矫治前后牙槽裂距的改变,观察治疗效果;用鼻外形的评价标准对术后患儿进行初步评价.结果经过 108～152 天的治疗,26 例单侧完全性唇腭裂齿槽左右裂隙较矫治前平均缩小 5.3 mm,前后裂距较矫治前平均缩小 3.5 mm;鼻外形评价的优良率为 76 %.12 例双侧完全性唇腭裂齿槽左侧裂隙平均缩小 4.7 mm,右侧裂隙平均缩小 4.2 mm,左右裂距平均扩大 1.6 mm,前后裂距平均缩小 5.1 mm,前牙槽突宽度平均增大 1.2 mm;鼻外形评价的优良率为 66 %.结论对完全性唇腭裂患者在新生儿期做术前鼻撑和正畸治疗,患儿易适应,有利鼻发育,可减小手术的难度,提高整复效果.

Objective To observe the clinical effect of presurgical nasoalveolar molding in infants with complete cleft lip and palate.Methods Presurgical nasoalveolar molding was performed in 38 infants with cleft lip and palate(26 patients with unilateral cleft lip and palate,12 patients with bilateral cleft lip and palate),aged between 5 and 30 days.The width of alveolar cleft was measured before and after the operation and the effect of treatment was assessed.Results After 108 152 days of therapy,the average width of alveolar cleft decreased by 5 3 mm in 26 patients with unilateral cleft lip and palate.Nasal profile was improved in 76 percent of cases.In 12 patients with bilateral cleft lip and palate,the average width of left cleft decreased by 4 7 mm and that of the right decreased by 4 2 mm.The distance between right and left cleft increased by 5 1 mm .Nasal profile was improved in 66 percent of cases. Conclusion Presurgical nasoalveolar molding in complete cleft lip and palate can improve nasal profile and decrease the width of alveolar cleft.