咽后壁瓣咽成形术对腭裂术后患者颌面部生长影响的初步研究

doi:10.7518/gjkq.2023022

摘要/Abstract

摘要：

目的通过对颌面部软、硬组织形态的测量分析，探讨咽后壁瓣咽成形术对腭裂术后患者颌面部生长的影响。方法对56例腭裂术后腭咽闭合不全患者，采用病例对照研究：A组21例，为腭裂术后行咽后壁瓣咽成形术患者；B组（对照组1）15例，为腭裂术后行Furlow腭再成形术患者；C组（对照组2）20例，为腭裂术后未行二期手术患者。对所有患者随访1年以上的X线头影侧位片进行测量，硬组织测量包含颅底、上颌骨、面高3个方面，软组织包含10个面部轮廓指标，用SPSS 21.0软件进行统计学分析。结果手术年龄4~7岁的咽瓣手术患者与同年龄行腭再成形术及腭裂术后未行二期手术患者相比较，在水平及垂直方向上，软、硬组织生长均未见明显差异。结论咽后壁瓣咽成形术对腭裂术后患者的颌面部生长发育没有明显影响。

关键词: 腭裂, 腭咽闭合不全, 咽后壁瓣咽成形术, Furlow腭再成形术, 颌面部生长发育

Abstract:

Objective The study aimed to analyze the effect of posterior pharyngeal flap surgery on the maxillofacial growth of patients after palatoplasty by measuring the maxillofacial soft and hard tissue morphology. Methods 56 cases were included in this study. Group A included 21 cases who had undergone posterior pharyngeal flap surgery after palatoplasty. Group B (Control Group 1) included 15 cases who had had Furlow palatoplasty surgery after palatoplasty. Group C(Control Group 2) included 20 patients who had not received secondary operation after palatoplasty. At least one year postoperative lateral cephalometric radiographs were obtained from all patients. Three aspects of hard tissue (skull base, maxilla, facial height) and 10 facial contour parameters of soft tissue were evaluated. SPSS 21.0 was used to analyze data. Results For the patients aged 4-7 years, there was no significant difference in the growth of soft and hard tissues among three groups in both horizontal and vertical directions. Conclusion Posterior pharyngeal flap surgery had no significant effect on maxillofacial growth and development in patients after palatoplasty.

Key words: cleft palate, velopharyngeal insufficiency, posterior pharyngeal flap, Furlow palatoplasty, maxillofacial growth and development

中图分类号:

R 782.12

张宇宁,曾妮,张焙,石冰,郑谦. 咽后壁瓣咽成形术对腭裂术后患者颌面部生长影响的初步研究[J]. 国际口腔医学杂志, 2023, 50(1): 66-71.

Zhang Yuning,Zeng Ni,Zhang Bei,Shi Bing,Zheng Qian.. A preliminary study of the effect of posterior pharyngeal flap surgery on the maxillofacial growth of patients after palatoplasty[J]. Int J Stomatol, 2023, 50(1): 66-71.

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参考文献 31

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项目	A组	B组	C组	P值
性别
男女	14	11	11	0.275
男女	7	4	9	0.275
一期腭裂手术年龄/岁	0.972±0.257	1.545±1.031	1.288±0.963	0.153
二期手术年龄/岁	5.143±0.854	5.467±0.743	-	0.235
复诊年龄/岁	8.429±2.039	8.267±1.163	8.900±1.334	0.467
腭裂类型
单纯腭裂单侧完全性唇腭裂双侧完全性唇腭裂	5	1	1	0.550
	11	10	18
	5	4	1

测量指标	A组	B组	C组	P值
SN/mm	60.906±4.026	62.207±6.464	60.817±3.303	0.731
S-Ba/SN	0.678±0.057	0.711±0.053	0.684±0.053	0.195
N-Ba/SN	1.538±0.050	1.572±0.085	1.545±0.054	0.260
N-S-Ba/°	132.838±6.305	132.663±4.849	132.808±6.226	0.996
PMP-A/SN	0.618±0.076	0.627±0.077	0.597±0.049	0.403
PMP-ANS/SN	0.704±0.063	0.722±0.075	0.684±0.046	0.206
Ba-A/SN	1.235±0.076	1.278±0.086	1.240±0.071	0.231
Ba-ANS/SN	1.321±0.065	1.372±0.091	1.328±0.065	0.101
Ba-PMP/SN	0.618±0.057	0.650±0.081	0.643±0.045	0.121
Ba-N-ANS/°	60.596±4.922	61.631±4.293	60.687±3.841	0.756
S-N-ANS/°	79.491±5.199	81.197±4.851	79.626±4.326	0.530
S-N-A/°	74.895±5.162	76.016±5.115	74.236±3.430	0.529
R-PMP/SN	0.654±0.087	0.631±0.087	0.657±0.069	0.603
A-NPg/SN	0.010±0.069	0.031±0.071	0.054±0.045	0.080
N-Me/SN	1.688±0.119	1.691±0.140	1.639±0.108	0.338
ANS-N/SN	0.788±0.066	0.767±0.094	0.749±0.047	0.200
ANS-Me/SN	0.900±0.079	0.924±0.059	0.890±0.088	0.456

测量指标	A组	B组	C组	P值
FH-N’Pg’/°	82.513±4.394	81.993±6.239	84.243±4.814	0.380
Sn-Pn/SN	0.202±0.045	0.203±0.045	0.207±0.037	0.916
Ss-Ls/SN	0.048±0.033	0.044±0.039	0.059±0.024	0.357
H-N’Pg’/°	11.511±8.332	9.182±5.983	9.449±5.785	0.522
Sn-H/SN	0.102±0.056	0.102±0.048	0.112±0.036	0.761
A-Sn/SN	0.162±0.056	0.165±0.041	0.177±0.032	0.453
Ls-Si/SN	0.222±0.039	0.219±0.053	0.220±0.036	0.975
Li-LsPg’/SN	0.055±0.044	0.071±0.030	0.084±0.042	0.088
Si-LsPg’/SN	0.032±0.023	0.041±0.024	0.032±0.020	0.445
Pg-Pg’/SN	0.169±0.034	0.168±0.046	0.174±0.036	0.852

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