双侧唇裂鼻畸形手术联合鼻模矫正初步探讨.docVIP

双侧唇裂鼻畸形手术联合鼻模矫正初步探讨 　　[摘要]目的：探讨唇鼻同期整复术结合术前鼻模矫正对双侧不完全性唇裂鼻畸形的矫治效果。方法：10例在早期行鼻模矫正的唇裂患儿在矫正前(T0)、唇鼻手术术前(T1) 、术后1周(T2) 、术后半年(T3)分别拍摄面部仰头位照片，用配对t检验分析比较双侧鼻孔及鼻小柱的对称性。结果：T0-T1双侧鼻孔的高度、宽度的对称性差异改变明显（P0.05），T1-T2鼻孔高度的对称性上差异明显（P0.05），T1-T2鼻底宽度/鼻小柱高度差异明显（P0.01），鼻小柱的倾斜度各个阶段之间改善明显（P0.05）。结论：应用唇鼻同期整复术结合鼻模矫治对于双侧不完全性唇裂患者是一种可靠的治疗模式。 　　[关键词]双侧不完全性唇裂；唇鼻同期整复术；鼻模；鼻对称性 　　[中图分类号]R782.2 [文献标识码]A [文章编号]1008-6455（2013）09-0719-04 　　 　　Preliminary investigation of surgery and nasal mold correction for bilateral cleft lip 　　REN Zhan-ping1,TAO Yong-wei1,CAO Hui-qin1,HOU Yu-xia2,LI Jin-feng1,MA Si-wei1 　　(1.Department of Cranio-Maxillofacial Trauma Plastic Surgery;2.Department of Orthodontics, Stomatology Hospital of Xian Jiaotong University College of Medicine,Xian 710004,Shaanxi, China) 　　 　　Abstract:ObjectiveTo explore the effect about same period lip nose repairing combined nasal mold correction for bilateral incomplete cleft lips nasal appearance.Methods Ten infants were treated with this treatment mode.Each patient was photographed at the initial visit(T0),Operation period (T1),a week(T2)and half a year(T3) after operation. The nasal symmetry and nose columella was analyzed with paired t test. ResultsThe asymmetry of nose height and width was significantly improved at T0-T1 stage(P0.05).The nasal floor width/nose columellar height was significantly improved at T1-T2 stage(P0.01),The inclination of the nose columella improved obvious during 4 stages（P0.05）.Conclusion Application combined with lip nose mold correction and period diorthosis for bilateral incomplete cleft palate patients is a reliable treatment mode. 　　Key words:bilateral incomplete cleft lip;synchronous cleft lip and nose repair;nose mode; nose asymmetry 　　先天性唇裂患者常表现为上唇组织的缺损、移位和鼻部畸形，鼻畸形的严重程度又与唇裂的程度呈正相关。双侧不完全性唇裂在前唇及鼻底部存在肌纤维的连接，但肌纤维数量明显减少且伴有超微结构不同程度的变异，造成双侧鼻翼基部下降、鼻底过宽、鼻小柱短小，鼻尖塌陷；双侧不完全性唇裂鼻畸形较轻，但也存在一定程度地不对称，患者家属的期望值也较高。近年来尽管多数学者单纯通过手术方式同期延长鼻小柱，纠正鼻软骨畸形，但术后容易复发，影响治疗效果[1-2]。依据鼻部软骨在婴儿出生后仍具有可塑性的特点和术前鼻模矫正对手术治疗的辅助作用，本研究旨在利用双侧不完全性唇