第十一章先天性唇面裂和腭裂课件.ppt

先天性畸形 第十二章先天性唇裂、面裂和腭裂(cleft lip;clefts cheek;cleft palate) 口腔颌面外科 (Oral and maxillofacial surgery) 王旭霞 (Wang Xu-Xia) [目的要求]( objective and requirement) 1.掌握颌面部的胚胎发育和唇、面裂和腭裂的形成、唇腭裂的临床分类、唇腭裂整复术前与术后护理、单侧唇裂的手术设计和定点及基本操作原理。 2.?熟悉腭裂手术的基本方法及其他治疗。 3.了解唇腭裂序列治疗的概念、面裂的诊断及治疗方法，了解牙槽突裂的分类及治疗原则。 第一节 胚胎发育与发病因素( prenatal development and aetiology) 一、胚胎发育 prenatal development 胚胎发育prenatal development 3w—额鼻突frontonasal process ; 上下颌突 (maxillary 、mandibular process); 口凹(oral pit) 5w---内、外侧鼻突 (medial、lateral nasal prominence); 嗅凹(olfactory pit) 7w--嗅凹底破裂--内鼻孔(internal nares) 上颌突与外侧鼻突--鼻孔底及上唇 ； 两侧内侧鼻突--鼻小柱、人中及前颌； 两侧下颌突-下颌 8w-继发腭突(secondary palatine process) ； 原发腭突； (Primarily palatine process) 腭形成 腭部发育 第8周—第12周 二、唇、面裂和腭裂的形成 In the early weeks of development, long before a child is born, the right and left sides of the lip and the roof of the mouth normally grow together. Occasionally, however, in about one of every 1000 babies, those sections dont quite meet. A child born with a separation in the upper lip is said to have a cleft lip. 三、发病因素(aetiology)It may be a combination of genetic (inherited) and environmental factors 1 genetic factor 2 nutritional factor 3 infection injury factor 4 endocrinic factor 5 certain drugs 6 physico injury 7 the use of alcohol or tobacco while?a woman?is pregnant 第二节唇裂(cleft lip) A cleft lip is a physical split or separation of the two sides of the upper lip and appears as a narrow opening or gap in the skin of the upper lip. This separation often extends beyond the base of the nose and includes the bones of the upper jaw and/or upper gum. 一.唇裂的患病率 唇裂（cleft lip）是最常见的先天性畸形。 患病率 1：1000 （ 1996年前） 1.625：1000（1996年后） 男女 1.5：1 微笑列车 唇裂的临床分类 clinical classification 根据裂隙部位分 1单侧唇裂(unilateral cleft)：不完全性(immaturity)、完全性(complete) 2双侧唇裂bilateral cleft)：不完全裂(immaturity) 、完全裂(complete) 、混合型裂(mixed type) 根据裂隙程度分： Ⅰ度唇裂 红唇部裂 Ⅱ度唇裂 上唇部分裂鼻底未裂 Ⅲ度唇裂