目的:这项研究的目的是比较出生时严重程度不同的单侧唇裂(UCL)手术患者的裂侧和非裂侧之间的鼻气道阻力,以及评估UCL患者和健康个体之间鼻气道阻力的差异。
方法:这项回顾性研究是在2023年2月至2024年3月期间,对112例UCL患者进行了原唇重建但未进行高级手术作为研究组,20例健康参与者作为对照组。研究组患者根据出生时唇裂的严重程度进行分组,分为隐匿性唇裂组,不完全唇裂组,和完整的唇裂组。鼻前测流术用于评估鼻阻力,包括吸气过程中的单边有效阻力(Reffin),到期(Reffex),和整个呼吸(ReffT),以及吸气(VRin)和呼气(VRex)期间的单边顶点阻力。Kolmogorov-Smirnov检验用于评估正常性。使用配对t检验来分析同一组患者中健康侧和受影响侧之间的鼻阻力差异。采用学生t检验分析不同唇裂程度患者的鼻阻力差异。P值<0.05被认为是统计学上显著的。
结果:隐匿性唇裂和不完全性唇裂组的鼻阻力在裂侧和非裂侧之间无显著差异,与对照组相似。然而,在完全唇裂组中,裂侧鼻阻力明显高于非裂侧和对照组。在群体中,完全性唇裂组对Reffin的裂侧有明显更高的鼻阻力,VRin,和ReffT与隐匿性裂隙组相比。
结论:了解不同程度手术的UCL患者的鼻阻力,有利于临床诊断和治疗。完全性唇裂患者在唇裂一侧有更严重的鼻塞,对吸入的影响大于呼气。对于这些患者来说,建议由耳鼻喉科医生治疗以改善鼻腔气流。
OBJECTIVE: The aim of this study was to compare the nasal airway resistance between the cleft and non-cleft sides in operated unilateral cleft lip (UCL) patients with varying severities at birth, as well as to assess the differences in nasal airway resistance between UCL patients and healthy individuals.
METHODS: This retrospective study was conducted on 112 UCL patients who have undergone primary lip reconstructions but not advanced surgeries as the study group and 20 healthy participants as the control group between February 2023 to March 2024. The study group patients were grouped based on the severity of their cleft lip at birth, divided into occult cleft lip group, incomplete cleft lip group, and complete cleft lip group. The anterior rhinomanometry was used to evaluate nasal resistance, including unilateral effective resistances during inspiration (Reffin), expiration (Reffex), and the entire breath (ReffT), as well as unilateral vertex resistance during inspiration (VRin) and expiration (VRex). The Kolmogorov-Smirnov test was used to assess normality. Paired t-tests were utilized to analyze the differences in nasal resistance between the healthy and affected sides within the same group of patients. Student\'s t-test was used to analyze the differences in nasal resistance among patients with different degrees of cleft lip. A p-value of <0.05 was considered statistically significant.
RESULTS: The nasal resistances of the occult cleft and incomplete cleft lip groups showed no significant differences between the cleft and non-cleft sides, and were similar to the control group. However, in the complete cleft lip group, the cleft side nasal resistance was significantly higher than the non-cleft side and control group. Among the groups, the complete cleft lip group had significantly higher nasal resistances on the cleft side for Reffin, VRin, and ReffT compared to the occult cleft group.
CONCLUSIONS: Understanding the nasal resistance of different degrees of operated UCL patients can benefit clinical diagnosis and treatment. Patients with complete cleft lip have more severe nasal obstruction on the cleft side, with greater impact on inhalation than exhalation. For these patients, treatment by an otolaryngologist is recommended to improve nasal airflow.