牙槽突裂对大龄唇裂继发鼻畸形影响的三维研究  

Three-dimensional reconstruction reveals the correlation between the extent of alveolar clefts and secondary nasal deformity in adults

作　　者：罗枭 陈宇[1] 石冰[1] 郑谦[1] 李承浩[1] Luo Xiao;Chen Yu;Shi Bing;Zheng Qian;Li Chenghao(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Cleft Lip and Palate Surgery,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)

机构地区：[1]口腔疾病研究国家重点实验室,国家口腔疾病临床医学研究中心,四川大学华西口腔医院唇腭裂外科,成都610041

出　　处：《华西口腔医学杂志》2023年第4期421-425,共5页West China Journal of Stomatology

基　　金：四川大学华西口腔医院临床研究项目(LCYJ2019-10,LCYJ2019-12,LCYJ2022-YF-4)。

摘　　要：目的探究单侧唇裂伴牙槽突裂大龄患者牙槽突裂隙程度与唇裂术后继发鼻畸形的关系,并比较单纯植骨对于改善继发鼻畸形的意义。方法选取27例单侧唇裂术后继发鼻畸形伴牙槽突裂患者,年龄16~30岁,其中13例行牙槽突裂植骨治疗,收集所有患者术前螺旋CT、植骨患者术后即刻及植骨成骨患者(n=10)术后6个月螺旋CT数据,利用Mimics软件进行三维重建测量,评估牙槽突裂宽度、高度、体积与鼻畸形的相关性及植骨前后鼻畸形的差异。结果随着牙槽突裂隙宽度的增加,双侧鼻翼基底宽度的差异越明显(P<0.05);随着牙槽突裂隙深度的增加,鼻翼基底倾斜角增大(P<0.05);与单纯牙槽突裂植骨术前相比,术后即刻鼻畸形的差异无统计学意义,术后6个月鼻翼基底倾斜角减小(P<0.05)。结论牙槽突裂与单侧唇裂术后鼻畸形尤其是鼻底畸形存在密切关系,单纯植骨能在一定程度改善鼻底畸形。Objective This study aimed to explore the relationship between alveolar cleft and secondary nasal deformity post unilateral cleft lip repair in adults.Methods A total of 27 patients aged 16−30 years old with unilateral secondary nasal deformity and alveolar cleft were included,13 of whom underwent bone grafting.Spiral CT data of all preoperative and postoperative patients who had alveolar bone grafting were collected.Then,Mimics software was used for three-dimensional reconstruction to evaluate the correlation between the width,height,and volume of the alveolar cleft and those of the nasal deformity.The difference in nasal deformity before and after alveolar bone grafting was also explored.Results The width of the alveolar cleft was positively correlated with the difference in bilateral nostril floor width(P<0.05).As the effective depth of the alveolar cleft increased,the sub-alare inclination angle largened(P<0.05).However,no significant difference was found in the nasal deformity between before and after alveolar bone grafting.Conclusion Alveolar cleft is closely related to secondary nasal deformities post unilateral cleft lip repair,especially nasal floor deformities.Alveolar bone grafting benefits adult patients for the improvement of secondary nasal deformities post unilateral cleft lip repair.

关 键 词：牙槽突裂 继发鼻畸形 三维重建 牙槽骨平衡 

分 类 号：R782.2[医药卫生—口腔医学]