单侧完全性唇聘裂患者正颌术后面中部健患侧软组织的变化  

Soft tissue changes in midfacial healthy and affected sides of unilateral cleft lip and palate patients after orthognathic surgery

作　　者：朱鑫飚 张若晨 万启龙 刘琦 撒国良 杨学文 Zhu Xinbiao;Zhang Ruochen;Wan Qiong;Liu Qi;Sa Guoiang;Yang Xuewen(Department of Oral and Marillofacial Surgery,Wuhan University Hospital of Stomatology/The State Key Laboratory Breeding Base of Basic Science of Stomatology(Hubei-MOST)&Key La-boratory of Oral Biomedicine Ministry of Education,Wuhan 430079,China)

机构地区：[1]武汉大学口腔医院颌面外科口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室,武汉430079

出　　处：《中华医学美学美容杂志》2023年第3期200-204,共5页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨唇聘裂继发颌骨畸形患者行LeFortI型截骨术后面中部特定区域软组织形态与厚度变化。方法2012年7月至2020年8月,武汉大学口腔医院颌面外科诊断为唇聘裂术后继发颌骨畸形患者22例,男16例、女6例,年龄17~28岁,平均20岁;均接受LeFortI型截骨术治疗。患者于术前3d(TO)、术后7d(T1)、术后12个月(T2)行锥形束断层成像扫描。用Dolphin 11.95软件和3DSlicer软件对面中部截骨线附近软组织进行测量和分析,并比较手术前后的差异。结果手术前后患侧软组织厚度P3、P5、P6、P8处均较健侧厚,差异有统计学意义(P<0.05)。T2-TO期截骨线下P5、P6、P7、P8、P9处可见患侧术后变薄程度较健侧明显,其中P6处差异有统计学意义(P<0.05)。在颊突点区域术后软组织不对称性较术前改善,术前患侧该区域较健侧平均突出0.63mm,术后为0.17mm,差异有统计学意义(P<0.05)。结论经LeFortI型截骨术前移上颌骨后,单侧唇聘裂继发颌骨畸形患者的面部不对称性有所改善,但健、患侧软组织厚度仍存在一定差异,患侧软组织厚度变化较健侧大。Objective To investigate the alterations in soft tissue morphology and thickness in the mid-face region of patients with cleft lip and palate(UCLP)secondary to maxillofacial deformity following Le Fort I osteotomy.Methods A total of 22 patients(16 males and 6 females aged from 17 to 28 years with an average of 20 years)diagnosed with cleft lip and palate secondary to maxillofacial deformity were collected from the Wuhan University Hospital of Stomatology from July 2o12 to Au-gust 2020.All patients underwent Le Fort I osteotomy.CBCT scans were obtained at TO(3 days be-fore surgery),T1(7 days after surgery),and T2(1 year after surgery).The Dolphinl1.95 software and 3D Slicer software were utilized to measure and analyze the soft tissue near the mid-face osteotomy line.Differences in soft tissue thickness before and after surgery were compared.Results Before and after the operation,the soft tissue thickness at P3,P5,P6,and P8 on the affected side was thicker than that on the healthy side,and the difference was statistically significant,with a P-value of<0.05.At P5,P6,P7,P8,and P9 below the osteotomy line at T2-To,the degree of postoperative thinning on the affected side was more apparent than that on the healthy side,and there was statistical significance at P6(P<0.05).The postoperative soft tissue asymmetry in the Ck region was improved compared with the preoperative one.The preoperative average protruding of the affected side was O.63 compared with the healthy side,and the postoperative value was o.17.The preoperative and postoper-ative Mann-Whitney U tests showed significantly statistical difference.Conclusions After Le Fort I osteotomy,the facial asymmetry of patients with unilateral cleft lip and palate secondary to maxillofa-cial deformity is improved.However,there is still a difference in the soft tissue thickness between the healthy side and the affected side,and the change in soft tissue thickness on the affected side is more significant than that on the healthy side.

关 键 词：唇裂 聘裂 三维重建 正颌外科 软组织 

分 类 号：R782.2[医药卫生—口腔医学]