成年唇腭裂患者术后颅面硬组织三维形态研究

A three-dimensional study of craniofacial morphology in adult patients with cleft lip and palate after surgery

目的:对单侧完全性唇腭裂(UCLP)术后成年患者颅面骨进行三维测量分析,总结其颅面骨三维结构特点。方法:选取18～25周岁UCLP术后成年患者(UCLP组)及因其他疾病就诊的正常唇、腭和正常患者(对照组)各30例,进行锥形束CT扫描,分别测量颅面部骨组织的某些线距和角度,对比2组间测量结果的差别。结果:反映颅基底形态的测量项目UCLP组与对照组相比较,均未发现显著差异;UCLP组的上颌长度、腭部长度与宽度均小于对照组,下颌骨下部宽度及下颌骨联合深度均低于对照组,下颌角角度则大于对照组;UCLP组颌间矢状向与垂直向关系与对照组无明显差异,颏部后缩较为明显。结论:唇腭裂因素及手术因素未对患者颅基底结构产生影响,上颌矢状向发育受限,腭部横向发育受限,上下颌骨间矢状向与垂直向关系基本维持正常。

Objective： To study the craniofacial feature of adult patients with unilateral cleft lip and palate after surgery by three-di- mensional analysis. Methods： The UCLP group comprised of 30 adult patients with unilateral cleft lip and palate after surgery, con- trol group comprised of 30 samples with normal lip palate and occlusion. The craniofacial bone of the samples was scanned by CBCT, the difference of the variables between the two groups was compared. Results： The measurement items which reflect the cranial bone structure in the UCLP group were similar to those in the control. The length of maxillary and palate and the width of palate in UCLP group were shorter than those in the control. The width and depth of the mandibular bottom in UCLP group were shorter than those in the control, but the gonial angle in UCLP group was larger than that in the control. The sagittal development of maxillary and the devel- opment of posterior face height were inadequate, the chin was retracted in UCLP group. Conclusion ： Patients with UCLP after surgery have the same cranial structure to the normal persons. The sagittal development of maxillary, the sagittal and transversal development of palate in UCLP patients are inadequate. Coordination mechanism can make the relationship between the maxillary and mandibular basi- cally normal.