双侧完全性唇腭裂患者的同期腭裂修复与齿槽嵴裂植骨

Simultaneous primary palate repair and alveolar bone grafting in unoperated bilateral cleft lip and palate patients over 8 years old

目的 分析 8岁以上双侧完全性腭裂患者同期行腭裂修复与齿槽嵴裂植骨的可行性及植骨效果。方法 对 15例同期行腭裂修复与齿槽嵴裂植骨的双侧完全性唇腭裂患者作回顾性研究。分析手术时间、术中出血、术后恢复和创口愈合情况。对术后随访的X线片进行植骨效果的客观评价。结果 所有手术均顺利完成 ,平均手术时间延长 5 2分钟 ,没有明显增加术中出血量 ,患者术后恢复好 ,无创口感染和植入骨暴露 ,植骨的临床成功率为 83.3% ,其中以 8～ 11岁组的成功率最高 (93.8% )。结论 双侧完全性腭裂患者的同期腭裂修复和齿槽嵴裂植骨是安全和可行的 ;对于 8岁以上的腭裂未修复的双侧完全性唇腭裂患者 ,均应同期完成腭裂修复与齿槽嵴裂植骨 ;双侧齿槽嵴裂同期植骨的最佳手术时间与二期植骨相同 ,为尖牙萌出前 ,年龄在 8～ 11岁之间。

Objective To analyze the applicability and results of simultaneous primary palate repair and alveolar bone grafting in unoperated bilateral complete cleft lip and palate patients.Methods A retrospective study was performed in a group of unoperated bilateral complete cleft lip and palate patients who received simultaneous primary palate repair and alveolar bone grafting.The duration of operation as well as the blood loss during the operation was recorded,and compared with those patients who received secondary alveolar bone grafting.The result of bone grafting was evaluated according to radiographs.Results All the operations were successful,and the wound healed well.The procedure of simultaneous primary palate repair and alveolar bone grafting did not prolong the operating time compared with simple alveolar bone grafting and no blood transfusion due to bone grafting was needed.The overall clinical successful rate of alveolar bone grafting in the group of patients was 83.3% ,and 8～11 year group had the highest successful rate.Conclusion Simultarneous primary palate repair and alveolar bone grafting are safe and applicable procedure for unoperated bilateral complete cleft lip and palate patients.The best time of the operation is before eruption of the canine,the age is 8～11 years,similar to secondary bone grafting for bilateral alveolar eleft.