唇裂修复术中上颌软组织潜行分离对上颌骨发育影响的实验研究

AN EXPERIMENTAL STUDY OF MAXILLA GROWTH FOLLOWING CLEFT LIP REPAIR WITH SOFT TISSUE UNDERMING

目的 应用 X线头颅侧位片测量和大体标本测量 ,观察兔上颌骨发育情况 ,了解上颌软组织潜行分离是否影响上颌骨发育。方法 日本大耳白兔 2 5只随机分为五组 ,每组各 5只。第一组作为对照组 ,以确定面部生长正常 (长度、角度 )值。第二组手术造成人工 (左侧 )单侧唇裂、齿槽突裂和腭裂模型 ,不作任何修复。第三组人工单侧唇腭裂模型 ,仅采取直线缝合法修复唇裂。第四组唇腭裂模型 ,以直线缝合法修复唇裂 ,但在缝合之前对左侧上颌骨行广泛软组织潜行分离。第五组修复唇裂方法 ,并对整个上颌骨软组织作潜行分离。结果 第四、五组 SNA角明显小于第一、二、三组 ;第一、二、三组之间相差较小。鼻根点至上齿槽座点的距离 ,第四、五组比其它三组短 ;上颌骨前后经 ,第四、五组左侧的长度也比其它三组短 ,而宽度则较宽。结论 唇裂手术中行上颌软组织广泛潜行分离将影响上颌骨发育 。

Objective The purpose of this study is to evaluate the effects of cleft lip repair with soft tissue underming on the growth of maxilla. Methods Twenty five 7 week old Japanese rabbits were assigned to five groups, each group with different treatment, that is group 1 as a contral one, group 2,3,4 and 5 as experimental one which artificial lip cleft repair with or without soft tissue underming. All animals were sacrificed at 20 weeks post operation. By direct cephalometrics and gross specimen measurement to measure the maxillary width, height and anteroposterior diameter. Results The experimental results showed that there were abnormality of maxillofacial width in group 4 and 5 respectively. The width in group 4,5 was wider than that in group 1,2,3 significantly, group 5 was the widest one. Compared with the control groups, the posterior facial width, anteroposterior diameter and height of maxilla in group 4 and 5 were also abnormal. Conclusion This study that the operations of relaxation incision at oral vestibule and extensive soft tissue underming refrain the growth and development of maxilla.