Abstract：
BACKGROUND: Presurgical plate therapy has been widely accepted as a treatment prior to palatal cleft closure. The effects of passive presurgical plate therapy on cleft morphology prior to single-stage unilateral cleft lip and palate (UCLP) repair were quantified.
METHODS: We compared the dimensions of cleft width and cleft area (true cleft and palatal cleft) measured preoperatively at 2 European cleft centers. Center A performed single-stage UCLP repair in 8-month-old infants without any presurgical orthopedic treatment. Center B initiated passive presurgical plate therapy immediately after the birth of the neonates, followed by single-stage UCLP repair at 8 months of age.
RESULTS: We included 28 patients with complete UCLP from Center A and 12 patients from Center B. The average anterior width of the true cleft before surgery was significantly smaller in infants at Center B than that in Center A (p = 0.001) with 95% confidence interval of (1.8, 5.7) mm, but the average posterior width was similar in the 2 groups. The mean presurgical true cleft area amounted to 106.8 mm2 (SD = 42.4 mm2) at Center A and 71.9 mm2 (SD = 32.2 mm2) at Center B, with a confidence interval for the difference being (9.8, 60.1) mm2. This corresponded to a 32.7% reduction of the true cleft area when passive presurgical plate therapy was used for the first 8 months of the infants\' life.
CONCLUSIONS: Passive presurgical plate therapy in UCLP significantly reduced the cleft area. Implications for the subsequent surgical outcome might depend on the surgical technique used.
METHODS: We compared the dimensions of cleft width and cleft area (true cleft and palatal cleft) measured preoperatively at 2 European cleft centers. Center A performed single-stage UCLP repair in 8-month-old infants without any presurgical orthopedic treatment. Center B initiated passive presurgical plate therapy immediately after the birth of the neonates, followed by single-stage UCLP repair at 8 months of age.
RESULTS: We included 28 patients with complete UCLP from Center A and 12 patients from Center B. The average anterior width of the true cleft before surgery was significantly smaller in infants at Center B than that in Center A (p = 0.001) with 95% confidence interval of (1.8, 5.7) mm, but the average posterior width was similar in the 2 groups. The mean presurgical true cleft area amounted to 106.8 mm2 (SD = 42.4 mm2) at Center A and 71.9 mm2 (SD = 32.2 mm2) at Center B, with a confidence interval for the difference being (9.8, 60.1) mm2. This corresponded to a 32.7% reduction of the true cleft area when passive presurgical plate therapy was used for the first 8 months of the infants\' life.
CONCLUSIONS: Passive presurgical plate therapy in UCLP significantly reduced the cleft area. Implications for the subsequent surgical outcome might depend on the surgical technique used.
摘要：
背景：术前钢板治疗已被广泛接受为pal裂闭合前的治疗方法。量化了被动术前钢板治疗对单阶段单侧唇腭裂（UCLP）修复前裂隙形态的影响。
方法：我们比较了2个欧洲裂隙中心术前测量的裂隙宽度和裂隙面积（真裂和腭裂）的尺寸。A中心对8个月大的婴儿进行了一期UCLP修复，没有进行任何术前骨科治疗。新生儿出生后，中心B立即开始被动术前钢板治疗，随后在8个月大时进行单阶段UCLP修复。
结果：我们纳入了来自A中心的28例完全UCLP患者和来自B中心的12例患者。手术前，在B中心的婴儿中，真实裂隙的平均前宽度明显小于A中心（p=0.001），95％置信区间为（1.8，5.7）mm，但两组的平均后部宽度相似。A中心的平均术前真实裂隙面积为106.8mm2（SD=42.4mm2），B中心为71.9mm2（SD=32.2mm2）。差值的置信区间为(9.8,60.1)mm2。当在婴儿生命的前8个月使用被动术前钢板治疗时，这相当于真实裂隙面积减少了32.7％。
结论：UCLP术前被动钢板治疗可显着减少裂隙面积。对后续手术结果的影响可能取决于所使用的手术技术。
方法：我们比较了2个欧洲裂隙中心术前测量的裂隙宽度和裂隙面积（真裂和腭裂）的尺寸。A中心对8个月大的婴儿进行了一期UCLP修复，没有进行任何术前骨科治疗。新生儿出生后，中心B立即开始被动术前钢板治疗，随后在8个月大时进行单阶段UCLP修复。
结果：我们纳入了来自A中心的28例完全UCLP患者和来自B中心的12例患者。手术前，在B中心的婴儿中，真实裂隙的平均前宽度明显小于A中心（p=0.001），95％置信区间为（1.8，5.7）mm，但两组的平均后部宽度相似。A中心的平均术前真实裂隙面积为106.8mm2（SD=42.4mm2），B中心为71.9mm2（SD=32.2mm2）。差值的置信区间为(9.8,60.1)mm2。当在婴儿生命的前8个月使用被动术前钢板治疗时，这相当于真实裂隙面积减少了32.7％。
结论：UCLP术前被动钢板治疗可显着减少裂隙面积。对后续手术结果的影响可能取决于所使用的手术技术。
