唇腭裂患者外鼻生长特征的研究进展

doi:10.7518/gjkq.2023055

摘要/Abstract

摘要：

唇腭裂畸形通常伴有外鼻形态异常，严重影响面部美观和生活质量。深入了解唇腭裂患者外鼻形态生长变化规律对治疗方案改进至关重要。本文通过横向汇总现有外鼻生长文献数据，系统介绍正常及唇腭裂人群外鼻形态指标随生长的变化趋势以及序列治疗对外鼻生长的医源性影响，在明确进一步研究方向的同时，为唇腭裂鼻畸形手术设计和治疗时机选择提供参考。

关键词: 唇腭裂, 鼻畸形, 外鼻生长, 序列治疗

Abstract:

Congenital cleft lip and palate is often associated with nasal deformity, impairing facial aesthetics and life quality. Thorough understanding of the dynamic changes of nasal morphology during growth is prerequisite for improving clinical management. This review pooled nasal growth data from current literature and systemically introduced the nasal growth pattern among normal and cleft population and iatrogenic influence exerted by sequence treatment, providing refe-rence to further researches and clinical decision-making concerning surgical techniques and timing.

Key words: cleft lip and palate, nasal deformity, nasal growth, team approach

中图分类号:

R 782.2

陈卓,石冰,李精韬. 唇腭裂患者外鼻生长特征的研究进展[J]. 国际口腔医学杂志, 2023, 50(3): 279-286.

Chen Zhuo,Shi Bing,Li Jingtao.. Characterizing the nasal growth among patients with cleft lip and palate[J]. Int J Stomatol, 2023, 50(3): 279-286.

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参考文献 60

1	Krane NA, Markey JD, Moneta LB, et al. Aesthetics of the nasal dorsum: proportions, light, and shadow[J]. Facial Plast Surg, 2017, 33(2): 120-124.
2	Pereira Nunes D, Tinoco C, Oliveira E Carmo D, et al. Intermediate osteotomies in rhinoplasty: a new perspective[J]. Eur Arch Otorhinolaryngol, 2017, 274(7): 2953-2958.
3	van der Heijden P, Korsten-Meijer AG, van der Laan BF, et al. Nasal growth and maturation age in adolescents: a systematic review[J]. Arch Otolaryngol Head Neck Surg, 2008, 134(12): 1288-1293.
4	Mercan E, Oestreich M, Fisher DM, et al. Objective assessment of the unilateral cleft lip nasal deformity using three-dimensional stereophotogrammetry: severity and outcome[J]. Plast Reconstr Surg, 2018, 141(4): 547e-558e.
5	Yao CA, Mulliken JB. The unilateral cleft lip nasal deformity: revisions within 20 years after primary correction[J]. Plast Reconstr Surg, 2021, 147(6): 1379-1387.
6	王炜. 鼻部整形美容外科学[M]. 杭州: 浙江科技出版社, 2012: 1-3.
	Wang W. Rhinoplasty[M]. Hangzhou: Zhejiang Science Press, 2012: 1-3.
7	Shi B, Huang HY. Computational technology for nasal cartilage-related clinical research and application[J]. Int J Oral Sci, 2020, 12(1): 21.
8	Flores-Mir C, Nebbe B, Major PW. Use of skeletal maturation based on hand-wrist radiographic analysis as a predictor of facial growth: a systematic review[J]. Angle Orthod, 2004, 74(1): 118-124.
9	Farkas LG, Ross RB, James JS. Anthropometry of the face in lateral facial dysplasia: the bilateral form[J]. Cleft Palate J, 1977, 14(1): 41-51.
10	Zankl A, Eberle L, Molinari L, et al. Growth charts for nose length, nasal protrusion, and philtrum length from birth to 97 years[J]. Am J Med Genet, 2002, 111(4): 388-391.
11	Sforza C, Grandi G, De Menezes M, et al. Age- and sex-related changes in the normal human external nose[J]. Forensic Sci Int, 2011, 204(1/2/3): 205.e1-205.e9.
12	Grill FD, Rau A, Bauer FX, et al. The absolute and relative effects of presurgical nasoalveolar moul-ding in bilateral cleft lip and palate patients compared with nasal growth in healthy newborns[J]. J Craniomaxillofac Surg, 2019, 47(7): 1083-1091.
13	Farkas LG, Posnick JC, Hreczko TM, et al. Growth patterns of the nasolabial region: a morphometric study[J]. Cleft Palate Craniofac J, 1992, 29(4): 318-324.
14	Buschang PH, de la Cruz R, Viazis AD, et al. Longitudinal shape changes of the nasal dorsum[J]. Am J Orthod Dentofacial Orthop, 1993, 104(6): 539-543.
15	Jankowska A, Janiszewska-Olszowska J, Grocholewicz K. Nasal morphology and its correlation to craniofacial morphology in lateral cephalometric analysis[J]. Int J Environ Res Public Health, 2021, 18(6): 3064.
16	Kim DC, Mulliken JB. Direct anthropometry of repaired bilateral complete cleft lip: a long-term assessment[J]. Plast Reconstr Surg, 2017, 140(2): 326e-332e.
17	Farmand M. Lip repair techniques and their in-fluence on the nose[J]. Facial Plast Surg, 2002, 18(3): 155-164.
18	Xu Y, Yang C, Schreuder WH, et al. Cephalometric analysis of craniofacial morphology and growth in unrepaired isolated cleft palate patients[J]. J Craniomaxillofac Surg, 2014, 42(8): 1853-1860.
19	Iwasaki T, Suga H, Minami-Yanagisawa A, et al. Upper airway in children with unilateral cleft lip and palate evaluated with computational fluid dynamics[J]. Am J Orthod Dentofacial Orthop, 2019, 156(2): 257-265.
20	Al-Rudainy D, Ju X, Mehendale F, et al. Assessment of facial asymmetry before and after the surgical repair of cleft lip in unilateral cleft lip and palate cases[J]. Int J Oral Maxillofac Surg, 2018, 47(3): 411-419.
21	Knight ZL, Ganske I, Deutsch CK, et al. The chan-ging nasolabial dimensions following repair of unila-teral cleft lip: an anthropometric study in late childhood[J]. Plast Reconstr Surg, 2016, 138(5): 879e-886e.
22	Kimura N, Nozoe E, Okawachi T, et al. Three-dimensional analyses of nasolabial forms and upper lip surface symmetry after primary lip repair in patients with complete unilateral cleft lip and palate[J]. J Craniomaxillofac Surg, 2019, 47(2): 245-254.
23	Seo HJ, Denadai R, Vamvanij N, et al. Primary rhinoplasty does not interfere with nasal growth: a long-term three-dimensional morphometric outcome study in patients with unilateral cleft[J]. Plast Reconstr Surg, 2020, 145(5): 1223-1236.
24	Harrison LM, Hallac RR, Derderian CA. Three-dimensional analysis of bilateral cleft lip and palate nasal deformity[J]. Cleft Palate Craniofac J, 2021, 58(1): 105-113.
25	Wei YH, Zhong TH, Yin X, et al. Dynamic nasola-bial growth after primary surgery for patients with bilateral cleft lip: a five-year follow-up study[J]. J Oral Maxillofac Surg, 2019, 77(10): 2125.e1-2122125.e10.
26	Garfinkle JS, King TW, Grayson BH, et al. A 12-year anthropometric evaluation of the nose in bila-teral cleft lip-cleft palate patients following nasoalveolar molding and cutting bilateral cleft lip and nose reconstruction[J]. Plast Reconstr Surg, 2011, 127(4): 1659-1667.
27	Dehghani M, Jahanbin A, Omidkhoda M, et al. Facial anthropometric evaluation of unilateral cleft lip and palate patients: infancy through adolescence[J]. J Craniofac Surg, 2018, 29(2): 353-357.
28	Xu Y, Li JT, Zhao SF, et al. Four-dimensional chan-ges of nasolabial positions in unilateral cleft lip and palate[J]. J Craniofac Surg, 2013, 24(2): 473-478.
29	Al-Rudainy D, Ju XY, Mehendale FV, et al. Longitudinal 3D assessment of facial asymmetry in unilate-ral cleft lip and palate[J]. Cleft Palate Craniofac J, 2019, 56(4): 495-501.
30	Rottgers SA, Lim SY, Hall AM, et al. Longitudinal photogrammetric analysis of the columellar-labial angle following primary repair of bilateral cleft lip and nasal deformity[J]. Plast Reconstr Surg, 2017, 139(5): 1190-1199.
31	Yoshimura Y, Okumoto T, Iijima Y, et al. Reduced nasal growth after primary nasal repair combined with cleft lip surgery[J]. J Plast Reconstr Aesthet Surg, 2015, 68(11): e159-e166.
32	Ishii K, Vargervik K. Nasal growth in complete bilateral cleft lip and palate[J]. J Craniofac Surg, 1996, 7(4): 290-296.
33	Pu LL, Liu RK, Shi B, et al. Radiologic evaluation of the influence of cleft treatment on nasal dorsum growth[J]. Cleft Palate Craniofac J, 2021, 58(6): 773-778.
34	Grayson BH, Santiago PE, Brecht LE, et al. Presurgical nasoalveolar molding in infants with cleft lip and palate[J]. Cleft Palate Craniofac J, 1999, 36(6): 486-498.
35	Kapadia H, Olson D, Tse R, et al. Nasoalveolar molding for unilateral and bilateral cleft lip repair[J]. Oral Maxillofac Surg Clin North Am, 2020, 32(2): 197-204.
36	Dinh TTN, van Nguyen D, Dien VHA, et al. Effectiveness of presurgical nasoalveolar molding app-liance in infants with complete unilateral cleft lip and palate[J]. Cleft Palate Craniofac J, 2022, 59(8): 995-1000.
37	Chou PY, Hallac RR, Ajiwe T, et al. The role of nasoalveolar molding: a 3D prospective analysis[J]. Sci Rep, 2017, 7(1): 9901.
38	Yilmaz RBN, Çakan DG. Nasolabial morphology following nasoalveolar molding in infants with unilateral cleft lip and palate[J]. J Craniofac Surg, 2018, 29(4): 1012-1016.
39	Ezzat CF, Chavarria C, Teichgraeber JF, et al. Presurgical nasoalveolar molding therapy for the treatment of unilateral cleft lip and palate: a preliminary study[J]. Cleft Palate Craniofac J, 2007, 44(1): 8-12.
40	Meazzini MC, Chiavenna C, Autelitano L, et al. Photometric evaluation in adolescence of patients with bilateral cleft lip and palate treated with nasoalveolar molding and primary columella lengthening[J]. Cleft Palate Craniofac J, 2018, 55(4): 568-573.
41	Bhutiani N, Tripathi T, Verma M, et al. Assessment of treatment outcome of presurgical nasoalveolar molding in patients with cleft lip and palate and its postsurgical stability[J]. Cleft Palate Craniofac J, 2020, 57(6): 700-706.
42	Nayak T, Parmar R, Bonanthaya K, et al. A longitudinal study of the nasal symmetry in unilateral cleft lip and palate patients treated with nasoalveolar molding[J]. Indian J Plast Surg, 2020, 53(3): 371-376.
43	Bonanthaya K, Jalil J. Management of the nasal deformity in the unilateral cleft of the lip and nose[J]. J Maxillofac Oral Surg, 2020, 19(3): 332-341.
44	Mbuyi-Musanzayi S, Tshilombo Katombe F, Lukusa Tshilobo P, et al. Anthropometric and aesthetic outcomes for the nasolabial region in 101 consecutive African children with unilateral cleft lip one year after repair using the anatomical subunit approximation technique[J]. Int J Oral Maxillofac Surg, 2017, 46(10): 1338-1345.
45	Thomson RM, Jovic T, Drake D, et al. Nasolabial appearance of bilateral cleft lip repair at five years of age. Comparing techniques of modified advancement-rotation (Delaire) with Manchester repair: a retrospective cohort study[J]. Br J Oral Maxillofac Surg, 2021, 59(10): 1214-1219.
46	Tse RW, Mercan E, Fisher DM, et al. Unilateral cleft lip nasal deformity: foundation-based approach to primary rhinoplasty[J]. Plast Reconstr Surg, 2019, 144(5): 1138-1149.
47	Yamanishi T, Kondo T, Kirikoshi S, et al. Morphological correlations in nasolabial formation after primary lip repair for unilateral cleft lip[J]. J Oral Ma-xillofac Surg, 2021, 79(10): 2126-2133.
48	Alazzawi O, Morioka D, Miyabe M, et al. Nasola-bial growth in individuals with unilateral cleft lip and palate: a preliminary study of longitudinal observation using three-dimensional stereophotogrammetry[J]. J Craniofac Surg, 2017, 28(5): e449-e451.
49	Liu YM, Huang HY, Shi B, et al. The influence of lip repair on the growth of craniofacial structures in bilateral cleft lip and palate patients with unoperated palate from childhood to adulthood[J]. J Craniofac Surg, 2020, 31(5): 1218-1222.
50	Thierens L, Brusselaers N, de Roo N, et al. Effects of labial adhesion on maxillary arch dimensions and nasolabial esthetics in cleft lip and palate: a syste-matic review[J]. Oral Dis, 2017, 23(7): 889-896.
51	肖苒, 徐慧芬, 石冰. 早期剥离术对鼻翼软骨生长发育影响的动物实验研究[J]. 华西口腔医学杂志, 1998, 16(4): 305-307.
	Xiao R, Xu HF, Shi B. The effect of carly surgical denudation on alar cartilage growth and development in animal study[J]. West China J Stomatol, 1998, 16(4): 305-307.
52	Seo HJ, Denadai R, Lo LJ. Long-term nasal growth after primary rhinoplasty for bilateral cleft lip nose deformity: a three-dimensional photogrammetric study with comparative analysis[J]. J Clin Med, 2019, 8(5): 602.
53	Hosseinian B, Rubin MS, Clouston SAP, et al. Comparative analysis of three-dimensional nasal shape of casts from patients with unilateral cleft lip and palate treated at two institutions following rotation advancement only (Iowa) or nasoalveolar molding and rotation advancement in conjunction with primary rhinoplasty (New York)[J]. Cleft Palate Craniofac J, 2018, 55(10): 1350-1357.
54	Brusati R, Meazzini MC, Rezzonico A, et al. Eva-luation of a sample of patients with unilateral cleft lip and palate treated with a two-stage protocol[J]. J Craniofac Surg, 2018, 29(8): 2058-2064.
55	Gulsen A, Okay C, Aslan BI, et al. The relationship between craniofacial structures and the nose in Anatolian Turkish adults: a cephalometric evaluation[J]. Am J Orthod Dentofacial Orthop, 2006, 130(2): 131.e15-131.e25.
56	孙文双. 骨性Ⅰ类儿童鼻上颌复合体的生长发育研究[D]. 济南: 山东大学, 2021.
	Sun WS. Growth and development study of naso-maxillary complex in children with class Ⅰ skeletal pattern[D]. Jinan: Shandong University, 2021.
57	徐晓琳, 范存晖, 韩欣颖, 等. 替牙期单侧完全性唇腭裂患者鼻上颌复合体对称性的锥形束CT研究[J]. 上海口腔医学, 2019, 28(3): 279-283.
	Xu XL, Fan CH, Han XY, et al. The symmetry of nasal maxillary complex of patients with unilateral complete cleft lip and palate at the stage of mixed dentition-a cone beam CT study[J]. Shanghai J Stomatol, 2019, 28(3): 279-283.
58	Koberg W, Koblin I. Speech development and ma-xillary growth in relation to technique and timing of palatoplasty[J]. J Maxillofac Surg, 1973, 1(1): 44-50.
59	Xu X, Cao CC, Zheng Q, et al. The influence of four different treatment protocols on maxillofacial growth in patients with unilateral complete cleft lip, palate, and alveolus[J]. Plast Reconstr Surg, 2019, 144(1): 180-186.
60	Goyenc YB, Gurel HG, Memili B. Craniofacial morphology in children with operated complete unilate-ral cleft lip and palate[J]. J Craniofac Surg, 2008, 19(5): 1396-1401.

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测量指标	定义
外鼻体积	近似于2个四面体的体积：基底为双侧鼻翼嵴点与鼻尖点连成平面，2个四面体的高分别为鼻根点和鼻下点至基底的垂直距离
外鼻表面积	近似为4个三角形鼻根点-鼻尖点-右鼻翼嵴点、鼻根点-鼻尖点-左鼻翼嵴点、鼻尖点-鼻下点-右鼻翼嵴点和鼻尖点-鼻下点-左鼻翼嵴点面积之和
鼻背长度	鼻根点-鼻尖点连线的距离
上鼻背角度	软组织鼻根点-软组织鼻骨点连线与蝶鞍点-鼻根点连线形成的夹角
下鼻背角度	鼻尖点-软组织鼻骨点连线与蝶鞍点-鼻根点连线形成的夹角
鼻底宽度	双侧鼻翼嵴点连线的距离
外鼻高度	软组织鼻根点-鼻下点连线的距离
鼻尖突度	鼻下点-鼻尖点连线的距离
鼻小柱角度	鼻下点-软组织鼻根点的连线与鼻下点-鼻尖点的连线形成的夹角
鼻小柱长度	鼻下点与连接双侧鼻孔最上内侧点连线的垂直距离
鼻唇角度	鼻小柱最前点-鼻下点的连线与鼻下点-上前唇最突出点的连线形成的夹角
鼻尖角度	软组织鼻根点-鼻尖点-鼻下点连线形成的角度
鼻尖矢状长度	经过鼻唇沟且垂直于眶耳平面的冠状平面至鼻尖点的线性距离

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