目的:本研究的目的是客观评估儿童非综合征性单侧唇腭裂(UCLP)初次治疗后残留的面部不对称程度,并将其与面部外观的主观评分相关联。
方法:采用立体测光法记录89例UCLP患儿的面部,以比较原发性裂口闭合后5年内的裂口侧和非裂口侧。计算均方根值以测量面部的left裂和非left裂的形状之间的差异,并与没有left裂的对照组进行比较。Asher-McDade美学指数(AMAI)用于通过12名外行人对鼻唇面积进行主观评分。
结果:唇裂(CL)患儿的RMS值与对照组相比没有显着差异。当评估仅限于鼻唇沟区时,发生了显着差异,然而,仅在唇裂(CLA)和唇裂(CLAP)患者中(p<0.001)。相比之下,主观评分显示,所有三个裂隙严重程度组的值均显着较高(CL,CLA,CLAP)与对照组相比(p<0.001)。RMS(均方根)值与AMAI评分之间存在非线性相关性。
结论:在UCLP初次闭合后,即使儿童面部对称性的非显著离散客观偏差也在主观评分中被警惕地记录,并在面部外观的判断中实施。
结论:3D立体测光术是一种监测裂患者不对称性的有效工具。
OBJECTIVE: The aim of the present study was to objectively assess the degree of residual facial asymmetry after primary treatment of non-syndromic unilateral cleft lip and palate (UCLP) in children and to correlate it with subjective ratings of facial appearance.
METHODS: Stereophotometry was used to record the faces of 89 children with UCLP for comparison of cleft and non-cleft sides up to 5 years after primary cleft closure. Root mean square values were calculated to measure the difference between the shape of cleft and non-cleft sides of the face and were compared to controls without a cleft lip. The Asher-McDade Aesthetic Index (AMAI) was used for subjective rating of the nasolabial area through 12 laypersons.
RESULTS: Children with a cleft lip (CL) showed no significant difference in RMS values compared to controls. Significant differences occurred when the evaluation was limited to the nasolabial area, however only in patients with cleft lip alveolus (CLA) and cleft lip palate (CLAP)(p < 0.001). In contrast, subjective ratings showed significantly higher values for all three cleft severity groups (CL, CLA, CLAP) compared to controls (p < 0.001). There was a non-linear correlation between the RMS (root mean square) values and the AMAI score.
CONCLUSIONS: Even non-significant discrete objective deviations from facial symmetry in children after primary closure of UCLP are vigilantly registered in subjective ratings and implemented in the judgement of facial appearance.
CONCLUSIONS: 3D stereophotometry is a usefull tool in monitoring asymmetry in patients with a cleft.