单侧完全性唇腭裂患儿鼻牙槽塑形术后3年临床效果分析

Analysis of three-year clinical effect of PNAM in complete unilateral cleft lip/palate

目的通过对单侧完全性唇腭裂患儿鼻牙槽塑形(PNAM)治疗前及术后3年鼻部对称性的测量,分析PNAM治疗术后3年的临床效果。方法选择2011年2月至2011年6月于西安交通大学附属口腔医院进行PNAM治疗的15例单侧完全性唇腭裂患儿,从PNAM治疗前至治疗后3年分为4个时间点:初次就诊(T0)、PNAM治疗结束(T1)、唇裂修复术后(T2)和治疗后3年(T3);拍摄正位和仰90°面部照片,在照片中标记12个鼻部标志点,进行16项测量。结果与T0进行相比,T1鼻背倾斜度和鼻小柱倾斜度明显减小(均P<0.05);与T1相比,T2鼻背倾斜度、鼻小柱倾斜度、患侧与健侧鼻翼高度比、患侧与健侧鼻底高度比、鼻底与内眦连线比均明显减小(均P<0.05),患侧鼻翼顶与鼻底高度比明显增大(均P<0.05);与T2相比,T3鼻小柱倾斜度有复发,其余测量指标差异均无统计学意义(均P>0.05)。结论 PNAM治疗可明显改善患儿鼻部对称性,鼻部形态在术后3年仍保持稳定。

Objective To evaluate the three-year clinical effect of presurgical nasoalveolar molding in unilateral complete cleft lip and palate（UCLP）. The nasal symmetry was accessed before and 3 years after PNAM.MethodsFifteen UCLP infants were included. There were 4 time points：before and after PNAM（T0 and T1）;after primary cheiloplasty and 3 years after treatment（T2 and T3）. Photos were taken;12 markers and 16 measurements were selected to access nasal symmetry. The measurements were columellar deviation,nasal bridge deviation,alanasi height,base nasiheight,ratio of the height of the alanasi and base nasi in healthy and affected side,the width and height of nostril in healthy and affected side,gradient of columella nasi,the ratio of the width and the height of nostril in both sides.ResultsCompared to T0：columellar deviation and nasal bridge deviation at T1 were significantly decreased（P〈0.05）;compared to T1：columellar deviation,nasal bridge deviation,the alanasi height,base nasi height in healthy and affected side and the ratio of the distance of endocanthion and base nasi at T2 were significantly decreased（P〈0.05）,while ratio of the height of the alanasi and base nasi was significantly increased（P〈0.05）. Compared to T2 the measurements didn＇t have significant change at T3（P〉0.05）.ConclusionPNAM and primary cheiloplasty will reconstruct the nasal morphology that can be maintained after three years.