目的:对平均年龄为5岁的单侧唇腭裂手术(UCLP)患者的颅颌面骨骼发育差异进行三维评估。
方法:分析了30例接受PNAM的UCLP患者和34例未接受PNAM的UCLP患者的锥形束CT照片。数据以DICOM文件格式存储,并导入到海豚成像程序中进行3D图像重建和地标识别。33个地标,通过使用Mann-WhitneyU检验,对代表颅面形态的17个线性变量和三个角度变量进行了分析和比较。
结果:反映颅面骨骼对称性的标志点的绝大多数线性变量和3D坐标在两组之间没有显着差异。在颅面骨骼发育方面,与非PNAM组相比,PNAM组的正中矢状面前鼻棘偏移明显较小,上颌长度较大.
结论:在儿童早期进行的评估表明,在新生儿期使用/不使用PNAM治疗不是影响UCLP患者颅颌面硬组织发育的主要因素;此外,PNAM治疗显示明显纠正了鼻子底部的骨骼偏差。
结论:在儿童早期的随访表明,在新生儿期进行的PNAM治疗不会阻碍上颌发育,并且在纠正鼻底偏曲方面具有益处。这是改善单侧唇腭裂患儿鼻畸形的可行选择。
OBJECTIVE: To three-dimensionally assess differences in craniomaxillofacial skeletal development in patients with operated unilateral cleft lip and palate (UCLP) treated with/without presurgical nasoalveolar molding (PNAM) with a mean age of 5 years.
METHODS: Cone-beam CT radiographs of 30 patients with UCLP who had undergone PNAM and 34 patients with UCLP who did not receive PNAM were analyzed. The data were stored in DICOM file format and were imported into the Dolphin Imaging program for 3D image reconstruction and landmark identification. 33 landmarks, 17 linear and three angular variables representing craniofacial morphology were analyzed and compared by using the Mann-Whitney U tests.
RESULTS: The vast majority of linear variables and 3D coordinates of landmark points reflecting craniofacial skeletal symmetry were not significantly different between the two groups. In terms of craniofacial skeletal development, the PNAM group had a significantly smaller anterior nasal spine offset in the midsagittal plane and a greater maxillary length compared to the non-PNAM group.
CONCLUSIONS: Evaluations performed in early childhood showed that treatment with/without PNAM in the neonatal period was not a major factor influencing craniomaxillofacial hard tissue development in patients with UCLP; moreover, PNAM treatment showed significant correction of skeletal deviation at the base of the nose.
CONCLUSIONS: Follow-up in early childhood has shown that PNAM treatment administered during the neonatal stage does not impede maxillary development and has benefits in correcting nasal floor deviation. It is a viable option for improving nasal deformity in children with unilateral cleft lip and palate.