Plastic and reconstructive surgery · 2019
The Influence of Four Different Treatment Protocols on Maxillofacial Growth in Patients with Unilateral Complete Cleft Lip, Palate, and Alveolus.
Оценочное исследованиеСтатьяНазвание и аннотация: Перевод в очереди
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Xu Xue, Cao Congcong, Zheng Qian, Shi Bing
Аннотация
BACKGROUND: The purpose of this study was to evaluate the effect of four different treatment protocols on maxillofacial growth in patients aged 7 to 8 years with unilateral complete cleft lip, palate, and alveolus.
METHODS: Sixty-one patients with nonsyndromic unilateral complete cleft lip, palate, and alveolus were entered into this study and grouped as follows: group 1 patients had a repaired lip and an unrepaired palate; group 2 patients underwent one-stage palatoplasty; group 3 patients underwent two-stage palatoplasty; and group 4 patients underwent lip adhesion and two-stage palatoplasty. The control group was composed of 16 patients with unilateral incomplete cleft lip. The Kolmogorov-Smirnov test was used to test the nature of data distribution. The Bonferroni test and the Kruskal-Wallis H test were used for multiple comparisons.
RESULTS: Group 5 showed a more protruding maxilla (basion-nasion-A point, basion-nasion-anterior nasal spine, sella-nasion-anterior nasal spine; p < 0.05), longer maxillary sagittal length (anterior nasal spine-posterior maxillary point; p < 0.05) and maxillary basal sagittal length (A point-posterior maxillary point; p < 0.05), and a better jaw relationship (A point-nasion-B point angle; p < 0.05) than groups 2, 3, and 4. Group 2 had higher anterior facial height (anterior nasal spine-nasion, anterior nasal spine-menton, nasion-menton; p < 0.05) and posterior facial height (registration point-posterior maxillary point; p < 0.05) than groups 3 and 4. Groups 2 and 3 had better maxillary position (sella-pterygomaxillary fissure; p < 0.05) and deeper bony pharynx (basion-posterior maxillary point; p < 0.05) than group 4.
CONCLUSIONS: In patients aged 7 to 8 years with unilateral complete cleft lip, palate, and alveolus, both one- and two-stage palatoplasty inhibited maxillary sagittal growth. Vomer flap repair with denuded bone inhibited maxillary vertical growth. Lip adhesion did adversely affect maxilla position.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
METHODS: Sixty-one patients with nonsyndromic unilateral complete cleft lip, palate, and alveolus were entered into this study and grouped as follows: group 1 patients had a repaired lip and an unrepaired palate; group 2 patients underwent one-stage palatoplasty; group 3 patients underwent two-stage palatoplasty; and group 4 patients underwent lip adhesion and two-stage palatoplasty. The control group was composed of 16 patients with unilateral incomplete cleft lip. The Kolmogorov-Smirnov test was used to test the nature of data distribution. The Bonferroni test and the Kruskal-Wallis H test were used for multiple comparisons.
RESULTS: Group 5 showed a more protruding maxilla (basion-nasion-A point, basion-nasion-anterior nasal spine, sella-nasion-anterior nasal spine; p < 0.05), longer maxillary sagittal length (anterior nasal spine-posterior maxillary point; p < 0.05) and maxillary basal sagittal length (A point-posterior maxillary point; p < 0.05), and a better jaw relationship (A point-nasion-B point angle; p < 0.05) than groups 2, 3, and 4. Group 2 had higher anterior facial height (anterior nasal spine-nasion, anterior nasal spine-menton, nasion-menton; p < 0.05) and posterior facial height (registration point-posterior maxillary point; p < 0.05) than groups 3 and 4. Groups 2 and 3 had better maxillary position (sella-pterygomaxillary fissure; p < 0.05) and deeper bony pharynx (basion-posterior maxillary point; p < 0.05) than group 4.
CONCLUSIONS: In patients aged 7 to 8 years with unilateral complete cleft lip, palate, and alveolus, both one- and two-stage palatoplasty inhibited maxillary sagittal growth. Vomer flap repair with denuded bone inhibited maxillary vertical growth. Lip adhesion did adversely affect maxilla position.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.