唇腭裂患儿的鼻牙槽塑形治疗：29例临床分析  

Presurgical nasoalveolar molding in infants with cleft lip and palate:analysis of 29 cases

作　　者：侯玉霞[1] 任战平[2] 李锦峰[2] 李湘琳[1] 马思维[2] 曹慧琴[2] 

机构地区：[1]西安交通大学口腔医院正畸科,陕西西安710004 [2]西安交通大学口腔医院口腔颌面外科,陕西西安710004

出　　处：《上海口腔医学》2011年第6期641-644,共4页Shanghai Journal of Stomatology

摘　　要：目的:采用鼻牙槽塑形器对唇腭裂患儿进行术前唇、牙槽裂隙及鼻畸形矫正,观察鼻牙槽塑形疗效,总结矫治过程中出现的问题及解决对策,为鼻牙槽塑形治疗的开展提供参考。方法:选择在本院接受鼻牙槽塑形治疗的患儿29例,其中单侧唇腭裂19例,双侧唇腭裂10例;初诊年龄为出生后3～150d,矫治周期2.5～3个月,每2周复诊,调整矫正器。结果:参照鼻牙槽塑形治疗评价标准,17例患儿矫治成功,唇、牙槽裂隙明显缩小,鼻不对称畸形明显改善,鼻小柱延长;9例好转,唇、鼻畸形部分纠正,利于手术;3例患者放弃治疗。结论:鼻牙槽塑形成功的关键因素包括初诊年龄、印模、腭护板和鼻撑的调整、鼻模的应用;正畸科需要与口腔颌面外科、整形外科医师取得共识,尽早给患儿开始治疗,以提高手术效果。PURPOSE：The objective of this study was to treat the cleft lip and alveolus,nasal deformity with presurgical nasoalveolar molding（PNAM）,to elucidate the problems and treatment methods,which may be helpful for the use of PNAM in clinic.METHODS： Twenty nine infants with cleft lip and palate（CLP） were treated with PNAM in our center.There were 19 unilateral and 10 bilateral CLP patients.The initial visit time was 3 to 150 days after birth.Treatment time ranged from 2.5 to 3 months.The appliance was modified at 2-week interval.RESULTS： According to the evaluation standards,17 infants were treated successfully with the closure of cleft lip and alveolar processes,reposition of the deformed nasal cartilages,and increased length of columella.The lip and nasal deformities of 9 infants were corrected partly,which were helpful for surgery.There were 3 infants giving up PNAM.CONCLUSIONS： There were five important facts for the successful treatment,including initial visit time,impression of the intraoral cleft defect,modification of the plate and the nasal stent,and use of nasal splints.Orthodontics and plastic surgeons should have the same views for PNAM in infants,which will advance the treatment level for cleft lip and palate.

关 键 词：唇腭裂 鼻牙槽塑形 正畸 婴儿 

分 类 号：R782.2[医药卫生—口腔医学]