唇腭裂患者鼻唇侧貌协调性评价的研究

Evaluation of nasolabial lateral profile harmony in cleft lip and palate patients

目的分析唇腭裂患者鼻尖突度、鼻上唇协调性、上下唇协调性主观评价与客观评价之间的相关性;并分析鼻突角、鼻唇角、唇间角在整体评价中的敏感程度。方法选取患者的150张标准侧面相进行评价。主观评价包括局部评价(鼻尖突度、鼻上唇协调性、上下唇协调性)及整体评价。局部评价采用VAS评分系统,整体评价采用等级评分系统;客观评价采用CAD软件测量鼻突角(∠A l-Ns-Prn)、鼻唇角(∠Cm-Sn-UL)、唇间角(∠UL-LL-C)。对鼻尖突度、上下唇协调性主观VAS评分与测量值进行Pearson相关分析,对鼻上唇协调性VAS评分与测量值进行二次方程的相关回归分析。依据整体等级评价结果分成三组,对三组间的鼻突角、鼻唇角、唇间角进行多因素方差分析。结果鼻突角与VAS评分相关系数r=0.443(P<0.01)。鼻唇角与VAS评分相关回归方程模型和相关回归系数检验P值均小于0.01。唇间角与VAS评分相关系数r=0.775(P<0.01)。三个指标在整体评价中的敏感性为:唇间角>鼻唇角>鼻突角。结论本研究采用的三个指标即鼻突角(∠A l-Ns-Prn)、鼻唇角(∠Cm-Sn-UL)、唇间角(∠UL-LL-C)可靠性高,与主观评价存在一定相关性,可应用于唇腭裂患者侧貌评价。

Objective To establish the indexes of evaluating the nasal tip projection,nasolabial harmony and interlips harmony and to analyze the correlation between the subjective and the objective evaluation.Methods A total of 150 standard lateral profile photographs of patients with cleft lip and palate were evaluated subjectively and objectively.The subjective evaluation included local（nasal tip protrusion,nasolabial harmony,and interlips harmony） and overall.VAS scoring system was utilized for local area screening and Likert scoring system for the overall evaluation.CAD software was used to measure the nasal prominence angle（∠ Al-Ns-Prn）,nasolabial angle（∠ Cm-Sn-UL） and interlips angle（∠ UL-LL-C）.Nasal tip projection and interlip harmony and the associated VAS were statistically analyzed using the Pearson correlation test,while nasolabial harmony and its VAS scores were analyzed by quadratic correlation and regression analysis.Three groups were established based on the overall evaluation results and then multivariate analysis of variance was used to analyze the nasal tip projection,nasolabial harmony and interlips harmony sensitivity.Results The correlation coefficient of nasal tip projection and its VAS r= 0.443（P0.01）.Nasolabial harmony and its VAS score： test of regression equation model P0.01,test of the regression coefficient P0.01.Interlips hamony and the associated VAS score correlation coefficient r= 0.775（P0.01）.The sensitivity of the three indexes was interlips angle nasolabial anglenasal prominence angle.Conclusion The three indexes,nasal prominence angle（∠ Al-Ns-Prn）,nasolabial angle（∠ Cm-Sn-UL） and interlips angle（∠ UL-LL-C） are reliable landmarks and there is a certain correlation between subjective and objective evaluation.