唇腭裂患者牵张成骨术后的侧貌变化  

The changes of racial profile after rigid external distraction in cleft lip and plate patients

作　　者：杨辛[1] 沈国芳[2] 张志愿[2] 杨小平[1] 廖贵清[1] 曾融生[1] 张志光[1] 

机构地区：[1]中山大学光华口腔医学院.附属口腔医院口腔颌面外科.口腔医学研究所,广东广州510055 [2]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科,上海200011

出　　处：《中国口腔颌面外科杂志》2009年第2期97-101,共5页China Journal of Oral and Maxillofacial Surgery

基　　金：国家高技术研究发展计划(863计划)资助项目(2002AA205011);上海市科委重点项目(074119511);上海市重点(优势)学科建设项目(Y0203)~~

摘　　要：目的:通过对唇腭裂术后继发上颌骨发育不足患者进行口外支架式前牵张治疗术后6～24个月的随访,观察分析其侧貌变化,为合理使用牵张器提供参考。方法:选取1998—2002年间上海交通大学医学院附属第九人民医院进行牵张成骨治疗、按时随访的唇腭裂患者14例进行术后随访分析。随访期分别为术后3、6、12、24个月,分别拍摄头颅定位侧位片及照片,记录患者的侧貌变化。结果:14例患者在牵张成骨术后6个月,至术后24个月,3例表现为双颌前突畸形,3例仍表现为面中部凹陷,1例表现为前牙开。结论:牵张成骨术治疗唇腭裂术后上颌骨发育不足患者具有一定优势,但牵张方向及牵张量难以控制,术后侧貌时不尽满意。因此,唇腭裂患者继发上颌骨发育不足在行牵张成骨术治疗时,应综合考虑多种因素的影响。PURPOSE： The purpose of this study is to evaluate the effects of maxillary advancement with Le Fort I osteotomy and the rigid external distraction （RED） in patients with cleft lip and palate （CLP）. METHODS： Thirty-nine CLP patients underwent maxillary advancement by Le Fort 1 osteotomy and RED between 1998 and 2002 in Shanghai Ninth People＇s Hospital. Among them, 14 patients who had a follow up with radiographic examinations at 3, 6, 12, and 24 months postoperatively were selected for this study. RESULTS： Seven patients had significant improvement in facial profiles and occlusions. However, bimaxillary protrusion and open bite were observed in 3 patients and 1 patient, respectively. Mild maxillary concave was noted in the other 3 patients. CONCLUSIONS： Distraction osteogenesis using RED in combination with Le Fort I osteotomy is a safe and predictable intervention in CLP patients with only limited, minor complications including bimaxillary protrusion and open bite. RED should focus on the direction and the length of distraction to improve the long-term facial profile and occlusion.

关 键 词：唇腭裂 牵张成骨 侧貌 

分 类 号：R782.2.3[医药卫生—口腔医学]