单侧唇腭裂鼻-牙槽骨塑形后同期唇-鼻-牙槽骨整复术VIP专享VIP免费

[收稿日期]2005-09-01;[修回日期]2005-12-22[作者简介]李锦峰(1964-),男,硕士,副主任医师[通讯作者]李锦峰,Tel:029-87254117,Fax:029-87273400,E-mail:ljf305@public.xa.sn.cnc2006年版权归《中国口腔颌面外科杂志》编辑部所有[文章编号]1672-3244(2006)01-0024-06单侧唇腭裂鼻-牙槽骨塑形后同期唇-鼻-牙槽骨整复术李锦峰1,牛百平2,任战平1,刘建华1,谈龙2(西安交通大学口腔医院1.口腔颌面整形外科,2.口腔正畸科,陕西西安710004)[摘要]目的:探讨唇腭裂婴幼儿术前鼻-牙槽骨塑形后的同期唇-鼻-牙槽骨整复术的方法与技术,并进行初步疗效评价。方法:对31例单侧完全性唇腭裂婴幼儿进行术前鼻-牙槽骨塑形及同期唇-鼻-牙槽骨整复术。术前鼻-牙槽骨塑形主要包括关闭牙槽骨间隙、唇牵张及鼻矫形;早期同期唇-鼻-牙槽骨整复术,即牙龈-牙周膜-牙槽骨整形术和改良Mohler法单侧唇裂唇鼻畸形同期整复术。采用SPSS10.0统计软件包对所得数据进行t检验。结果:31例唇腭裂婴幼儿经2～3个月术前鼻-牙槽骨塑形,唇裂隙宽度显著变窄(P<0.01),裂隙两侧唇组织适度牵张;鼻小柱延长及鼻塌陷畸形显著改善(P<0.05);牙槽裂隙显著变窄(P<0.01)。术后2例失访,29例患者随访6～30个月,结果显示:上唇和鼻形态俱佳,鼻小柱端正,鼻尖形态改善,双鼻孔、鼻底堤状隆起对称;口腔前庭-鼻腔瘘封闭;27例患者牙槽突裂隙关闭,牙槽骨连续性及稳定性增强并在原牙槽裂隙处有牙萌出,其中13例牙槽嵴高度、宽度及厚度不足;2例仍有1～2mm的牙槽裂隙。结论:单侧完全性唇腭裂患者为了获得理想的唇鼻形态及完整稳定的牙槽骨,术前进行鼻-牙槽骨塑形和同期唇-鼻-牙槽骨整复术是值得采用的序列治疗方法。[关键词]单侧完全性唇腭裂;婴幼儿;术前鼻-牙槽骨塑形;唇-鼻-牙槽骨整复术;唇腭裂序列治疗[中图分类号]R782.2.1[文献标识码]AEarlysimultaneouslip-nose-alveolarrepairfollowingpresurgicalnasoalveolarmoldingforinfantswithunilateralcleftlipandpalateLIJin-feng1,NIUBai-ping2,RENZhan-ping1,LIUJian-hua1,TANLong2.(1.DepartmentofOralandMaxillofacialSurgery,2.DepartmentofOrthodontics,HospitalofStomatology,Xi'anJiaotongUniversity.Xi'an710004,ShanxiProvince,China)[Abstract]PURPOSE:Toapplyanewtechniqueofearlysimultaneouslip-nose-alveolarrepairafterpresurgicalnasoalveolarmoldingininfantswithunilateralcompletecleftlipandpalateandevaluateitsoutcome.METHODS:31caseswithunilateralcompletecleftlipandpalateunderwentearlysimultaneouslip-nose-alveolarrepairfollowingpresurgicalnasoalveolarmolding.Thenasoalveolarmoldingincludedgap-closingofalveolarcleft,liptapingandnose-stentuntiltheageofapproximately3-5monthswhenthesurgerywasperformed.Unilateralgingivoperiosteoplastyaswellasthelipandnoserepairwereperformedinthesepatients.Student'sttestwasusedfordataanalysiswithSPSS10.0softwarepackage.RESULTS:Afternonsurgicalnose-alveolarmoldingin31infantswithcleftlipandpalateabout2-3months,thewidthofthecleftlipsinallcaseswassignificantlynarrowed(P<0.01),thesofttissueofbothsidesofthecleftsgrewandexpanded.Thedeformityofthecolumella,thedome,andthewidealarofthenosewassignificantlyreducedfollowingnonsurgicalnasoalveolarmolding(P<0.05).Thewidthofthealveolarcleftbecamesignificantlynarrowerinthesepatients(P<0.01).29operatedcaseswithsimultaneouslip-nose-alveolarrepairwerefollowedupfor6-30months.Thesecaseshadsatisfactorylip-nosecontourandclosedfistulasbetweenthenoseandtheoralcavity.After15-30monthsoffollowup,27casesgainedawholeuninterruptedalveoliandthedeciduousteetheruptedatthepreviousclefts.Buttherewerestilldeficienciesofheight,width,andthicknessofthealveolarridgein13cases,and1-2mmgapsofalveolarcleftsin2cases.CONCLUSIONS:Inordertoobtainsatisfactorylip-noseconfigurationanduninterruptedalveolarbonefor中国口腔颌面外科杂...