新生儿唇腭裂术前矫治方法与技术的临床探讨

Clinical study on the presurgical treatment methods for neonatal cleft lip and palate

目的:评价新生儿唇腭裂术前进行鼻-牙槽突-腭畸形矫治方法的疗效。方法:对28例单双侧唇腭裂新生儿进行术前鼻-牙槽突-腭畸形矫治治疗,在面部确定基点,利用数码相机拍射照片,通过image-Pro Plus5.1软件测量相关距离及角度,测量治疗前后的鼻小柱倾斜度、鼻小柱长度、鼻孔宽度和鼻孔高度。治疗前后取上颌石膏模型进行牙槽骨裂隙宽度的测量,比较矫治治疗前后腭部裂隙最大处及牙槽突裂隙的变化。结果:鼻小柱倾斜度平均减小27.11°,鼻孔宽度平均减小4.39 mm(单)或5.29 mm(双),鼻孔高度平均增加2.56 mm(单)或3.57 mm(双),牙槽突裂隙平均减少3.18 mm,腭部裂隙最大处平均减少5.77 mm。治疗前后的各项差异均有统计学意义(P<0.05),鼻塌陷畸形程度也得到显著改善。结论:术前进行鼻-牙槽突-腭畸形矫治治疗可为唇腭裂患者手术治疗创造有利条件,提高其整复效果。

Objective： To investigate the preliminary efficacy of presurgical nasal-alveolar process-palate deformity orthodontic therapy for the neonatal cleft lip and palate. Methods： Presurgical nasal-alveolar process-palate deformity orthodontic therapy was performed as presurgical orthodontic treatment in 28 infants（aged 7.98 d） with unilateral and bilateral cleft lip and palate. With determine basis points in the face, the use of digital cameras to shoot photos and distance and angle measurement by image-Pro Plus5.1 software. The columella inclination, columella length, nostril width and nostril height was measured before and after treatment. Before and after the treatment, to take the plaster model, alveolar bone fracture width was measured. The changes of the maxillary palate fissure and the alveolar process fracture was compared before and after treatment. The data were analyzed by SPSS 15.0. Results： The columella tilt was decreased about 27.11°,the nostrils width was decreased about 4.39 mm（single） or 5.29mm（double）, nostril height was increased about 2.56 mm（single） or 3.57mm（double）, the alveolar process fissure was reduced about 3.18mm. the maxillary palate fissure was reducd about 5.77 mm. Before and after treatment, measurement items had statistics difference（P〈0.05）. Deformity of the nasal collapse has also been significantly improved. Conclusion： Presurgical nasal-alveolar process-palate deformity orthodontic therapy for the neonatal cleft lip and palate in patients with cleft lip and palate is useful in cleft lip and palate team approach. and make it easy for the operation of cleft lip and palate.,and make it easy to create favorable conditions for subsequent surgical treatment.