这项研究的目的是评估术前鼻肺泡成型(PNAM)对单侧完全性唇裂(UCL/P)患者初次唇裂成形术后长期鼻对称性和塑形的疗效。
这是两组,平行,回顾性,随机临床试验。
这项研究的地点是桃园的长贡颅面中心,台湾。
患者分为以下两组之一:接受PNAM的UCL/P婴儿(PNAM组,n=42)和未接受PNAM的UCL/P婴儿(非PNAM组,n=42)。
干预措施包括PNAM和无鼻软骨解剖的初级唇缘成形术。
在这项研究中,对所有患者进行4至5年的术后全脸和下斜照相,并由10名医学评估人员评分1至5分。分数采用重复测量方差分析进行统计分析,P<0.05被认为具有统计学意义。
在进行PNAM1至3个月后,但在初次唇缘成形术之前,移位的鼻和牙槽软骨明显改善。然而,PNAM和非PNAM组术后4~5年的评分分别为66.62±14.25和66.31±15.08.两组间差异无统计学意义(F=0.009,P=.923)。
PNAM作为鼻畸形矫正的早期辅助治疗在初次唇缘成形术之前是有益的,但是,在没有鼻软骨解剖的情况下,初次唇缘成形术后,保持鼻孔的长期对称性是不够的。
The objective of this study was to assess the efficacy of presurgical nasoalveolar molding (PNAM) on long-term nasal symmetry and shaping after primary cheiloplasty in patients with unilateral complete cleft lip/palate (UCL/P).
This was a two-group, parallel, retrospective, randomized clinical trial.
The setting for this study was the Chang Gung Craniofacial Center in Taoyuan, Taiwan.
Patients were divided into one of the following two groups: infants with UCL/P who underwent PNAM (PNAM group, n = 42) and infants with UCL/P who did not undergo PNAM (non-PNAM group, n = 42).
Interventions included PNAM and primary cheiloplasty without nasal cartilage dissection.
In this study, 4- to 5-year postoperative full-face and submental oblique photographs were taken of all patients and scored from 1 to 5 points by 10 medical evaluators. The scores were statistically analyzed using repeated-measures analysis of variance, and P < .05 was considered to represent statistical significance.
After 1 to 3 months of PNAM but before primary cheiloplasty, the displaced nasal and alveolar cartilage showed obvious improvement. However, the scores in the PNAM and non-PNAM groups at 4 to 5 years postoperatively were 66.62 ± 14.25 and 66.31 ± 15.08, respectively. There was no significant difference between the two groups ( F = 0.009, P = .923).
PNAM as an early-stage adjunctive therapy for nasal deformity correction is beneficial before primary cheiloplasty, but it is insufficient to maintain long-term nostril symmetry after primary cheiloplasty without nasal cartilage dissection.