Abstract:
Unilateral complete cleft lip and palate (UCCLP) is one of the most severe clinical subphenotypes among nonsyndromic cleft lip and/or palate (NSCL/P), that complicates surgical repair operations. Presurgical nasoalveolar molding (PNAM) is a technique used to reshape the nose, lip and alveolar bone of infants with UCCLP before surgery (the modified Mohler rotation advancement cheiloplasty and two flap palatoplasty), with the potential to facilitate surgical repair. However, the effectiveness of PNAM treatment is still a matter of debate. In this paper, the 3Shape scanning system and 3dMD stereophotography were used to assess the short-term and long-term effects of PNAM treatment on the dental arch morphology and nasolabial features of patients with UCCLP, respectively. The findings indicated that PNAM treatment negatively affects both short-term and long-term dental arch shape compared to the treatment without PNAM, particularly in terms of limiting the transverse width of the maxillary canine-to-midline. Regarding the nasal and labial symmetry, PNAM improves the symmetry of the nasal alae in patients over 7 years old and the symmetry of the lip in patients under 7 years old. Moreover, UCCLP patients who received PNAM treatment exhibited a shorter and wider shape of the nostril on the cleft side compared to those without PNAM treatment. In clinical practice, the multidisciplinary team should carefully consider the advantages and disadvantages of the outcomes of PNAM treatment when treating infants with cleft lip and palate.
摘要:
单侧完全性唇腭裂(UCCLP)是非综合征性唇腭裂(NSCL/P)中最严重的临床亚型之一,这使得手术修复操作复杂化。术前鼻肺泡成型(PNAM)是一种用于重塑鼻子的技术,手术前使用UCCLP的婴儿的嘴唇和牙槽骨(改良的Mohler旋转推进唇缘成形术和两个皮瓣腭成形术),有可能促进手术修复。然而,PNAM治疗的有效性仍存在争议.在本文中,3Shape扫描系统和3dMD立体摄影用于评估PNAM治疗对UCCLP患者牙弓形态和鼻唇沟特征的短期和长期影响,分别。研究结果表明,与没有PNAM的治疗相比,PNAM治疗对短期和长期牙弓形状都有负面影响。特别是在限制上颌犬齿到中线的横向宽度方面。关于鼻和唇的对称性,PNAM改善了7岁以上患者的鼻翼对称性和7岁以下患者的嘴唇对称性。此外,与未接受PNAM治疗的患者相比,接受PNAM治疗的UCCLP患者在裂隙侧表现出较短和较宽的鼻孔形状。在临床实践中,多学科团队在治疗婴儿唇腭裂时,应仔细考虑PNAM治疗结局的利弊.