不同术式治疗单侧完全性唇腭裂的疗效及颌面形态影响研究

doi:10.13418/j.issn.1001-165x.2019.05.019

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (5) : 578-582. DOI: 10.13418/j.issn.1001-165x.2019.05.019

欧邦宾，　刘庭庭，　李迎霞

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Study of the effect of different treatment modalities on unilateral cleft lip and palate and its effect on the maxillofacial morphology

OU Bang-bin, LIU Ting-ting, LI Ying-xia

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摘要

目的　研究Millard法（旋转推进法）和改良Tennison法（三角瓣法）治疗单侧完全性唇腭裂的疗效及对患者颌面形态的影响。方法　根据治疗方法的不同，将本院收治的52例单侧完全性唇腭裂患者分为Millard治疗组和改良Tennison治疗组，每组26例。术后6个月，评价2组患者的临床疗效；并于手术治疗前后，采用照片测量法测量患儿的鼻部形态指标，包括Enw（内眦间距）、BAW（鼻部高度）、BADH（双侧鼻翼高度差）、CHW（口角间距）、CL（鼻小柱高度）、CW（鼻小柱宽度）、NBD（鼻背倾斜度）、CD（鼻小柱倾斜度），测量患儿的健侧和患侧唇高。结果　治疗后，改良Tennison组的临床修复优良率为88.46%，高于Millard组（69.23%），P<0.05。改良Tennison组平均BAW、CL、CW均大于对照组，平均BADH、CD均小于对照组（P＜0.05），改良Tennison组健侧-患侧唇高差小于Millard组（P<0.05）。结论　改良Tennison法治疗单侧完全性唇腭裂的整体疗效优于Millard法，能较好地保持鼻部和唇部形态的对称性，更好地控制患者颌面形态，维持颜面美观的形态学机制，值得临床推广应用。

Abstract

Objective　To study the effect of Millard (rotating propulsion) and modified Tennison (triangulation) in the treatment of unilateral complete cleft lip and palate and its effect on the shape of maxillofacial. 　Methods　According to the different treatment methods, 52 patients with an unilateral complete cleft lip and palate in our hospital were divided into a Millard treatment group and a modified Tennison treatment group (26 cases). Six months after operation, the clinical efficacy of the two groups was evaluated before and after the operation. The nasal morphological indexes of the children included Enw (medial canthus distance), BAW (nasal height), BADH (bilateral alar height difference), CHW (oral angle distance), CL (nasal columella height), CW (columella width), NBD (nasal dorsal inclination), And CD (tilt of nasal columella) were measured by photogrammetry, and the height of the healthy side and the affected side of the child were measured.　Results　In terms of the excellent rate of clinical repair, the Millard group and the modified Tennison group were 69.23% and 88.46%, respectively, and the modified Tennison group was higher than the Millard group (P<0.05). After treatment, the average BAW, CL and CW of the modified Tennison group were higher than those of the control group, and the average BADH and CD of the modified Tennison group were lower than those of the control group (P<0.05), and the difference of lip height between the healthy side and the affected side of the modified Tennison group was smaller than that of the Millard group (P<0.05).　Conclusions　The modified Tennison method is superior to the Millard method in the treatment of the unilateral complete cleft lip and palate. It can maintain the symmetry of nasal and lip morphology, have a better control the maxillofacial morphology of patients, and maintain the morphological mechanism of facial beauty. It is worthy of clinical application.

导出引用

欧邦宾, 刘庭庭, 李迎霞. 不同术式治疗单侧完全性唇腭裂的疗效及颌面形态影响研究[J]. 中国临床解剖学杂志. 2019, 37(5): 578-582 https://doi.org/10.13418/j.issn.1001-165x.2019.05.019

OU Bang-bin, LIU Ting-ting, LI Ying-xia. Study of the effect of different treatment modalities on unilateral cleft lip and palate and its effect on the maxillofacial morphology[J]. Chinese Journal of Clinical Anatomy. 2019, 37(5): 578-582 https://doi.org/10.13418/j.issn.1001-165x.2019.05.019

中图分类号： R782.2

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