Abstract：
OBJECTIVE: In recent years, many studies have reported that the presurgical nasoalveolar molding method improves the nose morphology; however, the reason for its effectiveness after surgery has never been understood. We evaluated the effect of nasoalveolar molding by comparing it with a passive orthopedic method without a nasal stent and focusing on the nostril morphology after primary cheiloplasty using various measurement methods. We then analyzed the essential factors.
METHODS: The patients involved were 31 infants with unilateral complete cleft lip and palate treated with primary cheiloplasty at the University of Tsukuba Hospital from 2004 to 2011. Of the 31 infants, 16 received nasoalveolar molding treatment and 15 received passive orthopedic treatment as controls. Photographic facial measurements were performed for all patients immediately and 7 months after primary cheiloplasty. The esthetics of the nostrils were assessed according to the left-right nostril symmetry, as measured by the Hausdorff distance, area ratio, perimeter ratio, and aspect a/u (the aspect ratio of the affected side)/(the aspect ratio of the unaffected side) ratio. In addition, the inclination of the nasal ridge was assessed using anthropometric measurements (Grc-Grn∠midline and midline∠columellar axis).
RESULTS: The area ratio, perimeter ratio, and Grc-Grn∠midline were significantly greater in the nasoalveolar molding group immediately after surgery (p = 0.00062, 0.016, and 0.048, respectively) than in the control group. However, the Hausdorff distance and aspect a/u ratio were more favorable (p = 0.0018 and 0.0039, respectively) in the nasoalveolar molding group after 7 months.
CONCLUSIONS: The results of our study suggested that using nasoalveolar molding as a presurgical orthopedic treatment could improve the shape of the nasal cartilage with surgeon\'s corrections.
METHODS: The patients involved were 31 infants with unilateral complete cleft lip and palate treated with primary cheiloplasty at the University of Tsukuba Hospital from 2004 to 2011. Of the 31 infants, 16 received nasoalveolar molding treatment and 15 received passive orthopedic treatment as controls. Photographic facial measurements were performed for all patients immediately and 7 months after primary cheiloplasty. The esthetics of the nostrils were assessed according to the left-right nostril symmetry, as measured by the Hausdorff distance, area ratio, perimeter ratio, and aspect a/u (the aspect ratio of the affected side)/(the aspect ratio of the unaffected side) ratio. In addition, the inclination of the nasal ridge was assessed using anthropometric measurements (Grc-Grn∠midline and midline∠columellar axis).
RESULTS: The area ratio, perimeter ratio, and Grc-Grn∠midline were significantly greater in the nasoalveolar molding group immediately after surgery (p = 0.00062, 0.016, and 0.048, respectively) than in the control group. However, the Hausdorff distance and aspect a/u ratio were more favorable (p = 0.0018 and 0.0039, respectively) in the nasoalveolar molding group after 7 months.
CONCLUSIONS: The results of our study suggested that using nasoalveolar molding as a presurgical orthopedic treatment could improve the shape of the nasal cartilage with surgeon\'s corrections.
摘要：
目的：近年来，许多研究报道，术前鼻肺泡成型方法改善了鼻子形态；然而，手术后其有效性的原因从未被理解。我们通过将其与没有鼻支架的被动矫形方法进行比较，并使用各种测量方法关注初次唇缘成形术后的鼻孔形态，来评估鼻肺泡成型的效果。然后，我们分析了必要的因素。
方法：所涉及的患者是2004年至2011年在筑波大学医院接受初级唇裂成形术治疗的31例单侧完全性唇裂婴儿。在31个婴儿中，16例接受了鼻肺泡成型治疗，15例接受了被动骨科治疗作为对照。在初次唇缘成形术后立即和7个月对所有患者进行照相面部测量。根据左右鼻孔对称性评估鼻孔的美学，用Hausdorff距离来衡量,面积比,周长比,以及纵横比a/u(受影响侧的纵横比)/(未受影响侧的纵横比)比。此外,采用人体测量法(Grc-Grn做中线和中线做小柱轴)评估鼻脊的倾斜度。
结果：面积比，周长比,术后即刻鼻肺泡成型组的Grc-Grn中位数中线明显大于对照组(p分别为0.00062、0.016、0.048)。然而,7个月后，鼻肺泡成型组的Hausdorff距离和纵横a/u比更为有利（分别为p=0.0018和0.0039）。
结论：我们的研究结果表明，使用鼻肺泡成型作为术前矫形治疗可以通过外科医生的矫正改善鼻软骨的形状。
方法：所涉及的患者是2004年至2011年在筑波大学医院接受初级唇裂成形术治疗的31例单侧完全性唇裂婴儿。在31个婴儿中，16例接受了鼻肺泡成型治疗，15例接受了被动骨科治疗作为对照。在初次唇缘成形术后立即和7个月对所有患者进行照相面部测量。根据左右鼻孔对称性评估鼻孔的美学，用Hausdorff距离来衡量,面积比,周长比,以及纵横比a/u(受影响侧的纵横比)/(未受影响侧的纵横比)比。此外,采用人体测量法(Grc-Grn做中线和中线做小柱轴)评估鼻脊的倾斜度。
结果：面积比，周长比,术后即刻鼻肺泡成型组的Grc-Grn中位数中线明显大于对照组(p分别为0.00062、0.016、0.048)。然而,7个月后，鼻肺泡成型组的Hausdorff距离和纵横a/u比更为有利（分别为p=0.0018和0.0039）。
结论：我们的研究结果表明，使用鼻肺泡成型作为术前矫形治疗可以通过外科医生的矫正改善鼻软骨的形状。
