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目的:通过对唇腭裂术后继发上颌骨发育不足患者进行口外支架式前牵张治疗术后6～24个月的随访,观察分析其侧貌变化,为合理使用牵张器提供参考。方法:选取1998—2002年间上海交通大学医学院附属第九人民医院进行牵张成骨治疗、按时随访的唇腭裂患者14例进行术后随访分析。随访期分别为术后3、6、12、24个月,分别拍摄头颅定位侧位片及照片,记录患者的侧貌变化。结果:14例患者在牵张成骨术后6个月,至术后24个月,3例表现为双颌前突畸形,3例仍表现为面中部凹陷,1例表现为前牙开。结论:牵张成骨术治疗唇腭裂术后上颌骨发育不足患者具有一定优势,但牵张方向及牵张量难以控制,术后侧貌时不尽满意。因此,唇腭裂患者继发上颌骨发育不足在行牵张成骨术治疗时,应综合考虑多种因素的影响。
OBJECTIVE: To observe the change of the profile of the patients with postoperative cleft lip and palate secondary maxillary underdevelopment after 6 ~ 24 months after operation, and to provide a reference for rational use of distractor. Methods: During the period of 1998-2002, the Ninth People’s Hospital Affiliated to Shanghai Jiaotong University School of Medicine was selected for the treatment of distraction osteogenesis. Fourteen patients with cleft lip and palate followed up on a follow-up analysis. The follow-up periods were 3, 6, 12 and 24 months after surgery. The lateral cranial positioning films and photographs were taken respectively to record the change of the profile of the patients. Results: Fourteen patients underwent distraction osteosynthesis from 6 months to 24 months postoperatively, 3 cases showed bimaxillary protrusion deformity, 3 cases still showed midface depression, and 1 case showed anterior tooth opening . CONCLUSION: Distraction osteogenesis in the treatment of patients with maxillary hypoplasia after cleft lip and palate surgery has some advantages, but it is difficult to control the direction of stretch and the amount of distraction. Postoperative facial features are not satisfied. Therefore, patients with cleft lip and palate secondary maxillary hypoplasia in the treatment of distraction osteogenesis should be considered a variety of factors.