3dMD评估双侧完全性唇裂的效果

Efficacy of repair of bilateral complete cleft lip and nasal deformity by 3dMD face system

目的探讨3dMD成像系统结合颌面部解剖标志点测量评估Mulliken法一期修复双侧完全性唇裂患儿唇鼻畸形的效果。方法选取2014年1月至2016年12月就诊于武汉大学口腔医院双侧完全唇裂患儿31例,平均手术年龄6个月。手术一期修复患儿唇鼻部畸形,患儿定期复查并拍摄3dMD影像,测量记录术后鼻唇部7项指标数据。结果一期修复双侧完全性唇裂唇鼻形态良好,上唇及鼻部畸形得到明显矫正,鼻外形基本对称,鼻小柱充分延长,显示良好鼻尖突度,鼻穹隆形态弧形向上,白唇嵴连续性完整,唇珠形态丰满。上唇总高度(Sn-Sto),唇珠厚度(Ls-Sto),鼻尖突度(Nh)及鼻小柱高度(Ch)均得到明显改善,与非唇腭裂儿童对照组相应鼻唇指标比较,差异无统计学意义;唇裂组鼻翼宽度(Nw)大于对照组鼻翼宽度;白唇高度(Sn-Ls)小于对照组,鼻唇角大小为148.38°,与对照组比较,差异有统计学意义。结论用Mulliken法功能性修复双侧完全性唇裂,能有效纠正鼻唇畸形,定期随访临床效果良好。

Objective To assess the effectiveness of the Mulliken's method in bilateral complete cleft lip patients with 3dMD system and anthropometric landmarks. Methods Thirty-one infants with bilateral complete cleft lip received treatment in Hospital of Stomatology, Wuhan University between January 2014 and December 2016. Patients underwent primary cheiloplasty and nasoplasty by the same senior surgeon. Periodic review was taken to measure and record the 7 items in the nasolabial area with three-dimensional (3D) images. Results The labial and nasal deformities were restored after primary surgery. The upper lip and nose were corrected and obtained the symmetric shape. The columella was elongated to acquire favorable nasal tip. The arc of nasal fornix was upward. The ridge of the white lip was continuous and integrated with full vermilion tubercle. Total length of upper lip (Sn-Sto), thickness of the vermilion tubercle (Ls-Sto), protrusion of the nasal tip (Nh) and columellar height (Ch) were markedly improved and there were no significant difference between the observation group and the control group. The significant differences between two groups occurred in values of the nostril width (Nw), which was greater than control group and white lip height (Sn-Ls) and lower than that of control group. Conclusions Mulliken's method during the primary cheiloplasty of the bilateral complete cleft lip shows better results in correction the nasal deformity and the ideal effects are achieved during follow-up.