唇腭裂新生儿术前矫治方法与技术的探讨及术后疗效评价  

Simultaneous lip-nose repair following presurgical nasoalveolar molding for infants with unilateral cleft lip and palate

作　　者：杨欣[1] 封兴华[1] 陆斌[1] 吴国锋[2] 

机构地区：[1]西安第四军医大学口腔医院口腔颌面整形外科,710032 [2]西安第四军医大学口腔医院口腔修复科,710032

出　　处：《实用口腔医学杂志》2009年第2期206-210,共5页Journal of Practical Stomatology

摘　　要：目的:探讨唇腭裂新生儿术前鼻-腭-牙槽骨矫形的方法与技术并进行初步疗效评价。方法:对10例单侧唇腭裂新生儿(包括2例伴对侧I度唇裂)进行术前鼻-腭-牙槽骨矫形主要包括鼻矫形、恢复牙弓形态、减小腭部裂隙;矫形后用改良Millard法行单侧唇裂唇鼻畸形同期整复术。采用SPSS15.0统计软件包对所得数据进行t检验。结果:10例唇腭裂新生儿经3个月左右术前鼻-腭-牙槽骨矫形,鼻小柱高度、鼻塌陷畸形显著改善及鼻小柱歪斜度减小(P<0.01);唇部软组织裂隙宽度显著变窄(P<0.05),牙槽裂隙及腭部裂隙显著变窄(P<0.01)。经矫形的患儿术后鼻对称性得到很好的恢复;唇部形态恢复佳。结论:唇腭裂患者术前进行鼻-腭-牙槽骨矫形是值得采用的序列治疗方法。Objective： To evaluate the curative effect of presurgieal nasoalveolar molding （PNAM） therapy in the treatment of infants with cleft lip and palate. Methods： 10 infants with cleft lip and palate underwent simultaneous lip and nose repair following presurgical nasoalveolar molding. The nasoalveolar molding included gap-closing of alveolar cleft and nose-stent until the age of approximately 3 -5 months when the surgery was performed. Student＇s t test was used for data analysis with SPSS 15, 0 software. Results： After nonsurgical nose-alveolar molding in 10 infants with cleft lip and palate about 2 - 3 months, the width of the cleft lips in all cases was significantly narrowed （P 〈 0.01 ） ,the soft tissue of both sides of the clefts grew and expanded. The deformity of the columella, the dome, and the wide alar of the nose was significantly reduced following nonsurgieal nasoalveolar molding（ P 〈 0.01 ）. The width of the alveolar cleft became significantly narrower in these patients（ P 〈 0.01 ）. Conclusion： In order to obtain satisfactory lip-nose configuration for unilateral complete cleft lip and palate, the presurgical nasoalveolar molding and early simuhaneous lip-nose repair are useful in cleft lip and palate team approach.

关 键 词：唇腭裂 新生儿 术前鼻-腭-牙槽骨矫形 唇腭裂序列治疗 

分 类 号：R782.21[医药卫生—口腔医学] R782.22[医药卫生—临床医学]