牙槽突裂对大龄唇裂继发鼻畸形影响的三维研究

doi:10.7518/hxkq.2023.2022466

华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (4): 421-425.doi: 10.7518/hxkq.2023.2022466

牙槽突裂对大龄唇裂继发鼻畸形影响的三维研究

罗枭(), 陈宇, 石冰, 郑谦, 李承浩()

口腔疾病研究国家重点实验室国家口腔疾病临床医学研究中心四川大学华西口腔医院唇腭裂外科，成都 610041

收稿日期:2022-11-22 修回日期:2023-04-28 出版日期:2023-08-01 发布日期:2023-07-21
通讯作者: 李承浩 E-mail:2577543004@qq.com;leechenghao@scu.edu.cn
作者简介:罗枭，硕士，E-mail：2577543004@qq.com
基金资助:
四川大学华西口腔医院临床研究项目(LCYJ2019-10)

Three-dimensional reconstruction reveals the correlation between the extent of alveolar clefts and secondary nasal deformity in adults

Luo Xiao(), Chen Yu, Shi Bing, Zheng Qian, Li Chenghao.()

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2022-11-22 Revised:2023-04-28 Online:2023-08-01 Published:2023-07-21
Contact: Li Chenghao. E-mail:2577543004@qq.com;leechenghao@scu.edu.cn
Supported by:
The Clinical Research Project of West China Hospital of Stomatology, Sichuan University(LCYJ2019-10);Correspondence: Li Chenghao, E-mail: leechenghao@scu.edu.cn

摘要/Abstract

摘要：

目的探究单侧唇裂伴牙槽突裂大龄患者牙槽突裂隙程度与唇裂术后继发鼻畸形的关系，并比较单纯植骨对于改善继发鼻畸形的意义。方法选取27例单侧唇裂术后继发鼻畸形伴牙槽突裂患者，年龄16~30岁，其中13例行牙槽突裂植骨治疗，收集所有患者术前螺旋CT、植骨患者术后即刻及植骨成骨患者（n=10）术后6个月螺旋CT数据，利用Mimics软件进行三维重建测量，评估牙槽突裂宽度、高度、体积与鼻畸形的相关性及植骨前后鼻畸形的差异。结果随着牙槽突裂隙宽度的增加，双侧鼻翼基底宽度的差异越明显（P<0.05）；随着牙槽突裂隙深度的增加，鼻翼基底倾斜角增大（P<0.05）；与单纯牙槽突裂植骨术前相比，术后即刻鼻畸形的差异无统计学意义，术后6个月鼻翼基底倾斜角减小（P<0.05）。结论牙槽突裂与单侧唇裂术后鼻畸形尤其是鼻底畸形存在密切关系，单纯植骨能在一定程度改善鼻底畸形。

关键词: 牙槽突裂, 继发鼻畸形, 三维重建, 牙槽骨平衡

Abstract:

Objective This study aimed to explore the relationship between alveolar cleft and secondary nasal deformity post unilateral cleft lip repair in adults. Methods A total of 27 patients aged 16-30 years old with unilateral secondary nasal deformity and alveolar cleft were included, 13 of whom underwent bone grafting. Spiral CT data of all preoperative and postoperative patients who had alveolar bone grafting were collected. Then, Mimics software was used for three-dimensional reconstruction to evaluate the correlation between the width, height, and volume of the alveolar cleft and those of the nasal deformity. The difference in nasal deformity before and after alveolar bone grafting was also explored. Results The width of the alveolar cleft was positively correlated with the difference in bilateral nostril floor width (P<0.05). As the effective depth of the alveolar cleft increased, the sub-alare inclination angle largened (P<0.05). However, no significant difference was found in the nasal deformity between before and after alveolar bone grafting. Conclusion Alveolar cleft is closely related to secondary nasal deformities post unilateral cleft lip repair, especially nasal floor deformities. Alveolar bone grafting benefits adult patients for the improvement of secondary nasal deformities post unilateral cleft lip repair.

Key words: alveolar cleft, secondary nasal deformity, three-dimensional reconstruction, alveolar bone balance

中图分类号:

R 782.2

罗枭, 陈宇, 石冰, 郑谦, 李承浩. 牙槽突裂对大龄唇裂继发鼻畸形影响的三维研究[J]. 华西口腔医学杂志, 2023, 41(4): 421-425.

Luo Xiao, Chen Yu, Shi Bing, Zheng Qian, Li Chenghao.. Three-dimensional reconstruction reveals the correlation between the extent of alveolar clefts and secondary nasal deformity in adults[J]. West China Journal of Stomatology, 2023, 41(4): 421-425.

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参考文献 16

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项目	牙槽突裂宽度			牙槽突裂深度			牙槽突裂体积
项目	a值	P值	R²值	a值	P值	R²值	a值	P值	R²值
鼻翼基底宽度	0.467	0.003	0.301	0.211	0.621	0.010	1.371	0.110	0.099
鼻孔宽度	0.005	0.960	0	-0.140	0.573	0.013	-0.214	0.677	0.007
鼻翼长度	0.260	0.118	0.095	-0.154	0.716	0.005	0.564	0.518	0.017
鼻孔高度	-0.100	0.811	0.002	-0.088	0.387	0.030	-0.024	0.909	0.001
鼻翼高度	-0.046	0.652	0.008	-0.085	0.737	0.005	0.748	0.143	0.084
鼻小柱倾斜角	0.811	0.145	0.083	-0.299	0.832	0.002	3.521	0.220	0.059
鼻翼倾斜角	0.140	0.327	0.038	0.436	0.217	0.060	1.215	0.092	0.109
鼻翼基底倾斜角	0.276	0.133	0.088	1.303	0.002	0.317	0.121	0.900	0.001
鼻翼角	0.221	0.547	0.015	0.416	0.649	0.008	2.325	0.212	0.062

测量指标	术前平均值	术后平均值	P值
鼻翼基底宽度/mm	4.076	3.661	0.424
鼻孔宽度/mm	1.919	2.370	0.365
鼻翼长度/mm	3.215	3.241	0.960
鼻孔高度/mm	2.086	1.953	0.537
鼻翼高度/mm	1.929	2.102	0.639
鼻小柱倾斜角/°	12.496	10.788	0.370
鼻翼倾斜角/°	4.037	4.275	0.716
鼻翼基底倾斜角/°	3.610	5.121	0.054
鼻翼角/°	9.566	13.424	0.087

测量指标	术前平均值	术后平均值	P值
鼻翼基底宽度/mm	3.598	4.650	0.498
鼻孔宽度/mm	1.665	1.817	0.763
鼻翼长度/mm	3.226	4.446	0.319
鼻孔高度/mm	2.278	2.039	0.569
鼻翼高度/mm	1.673	1.171	0.193
鼻小柱倾斜角/°	13.619	13.503	0.556
鼻翼倾斜角/°	3.525	3.598	0.931
鼻翼基底倾斜角/°	3.827	2.257	0.030
鼻翼角/°	12.674	10.472	0.347

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牙槽突裂对大龄唇裂继发鼻畸形影响的三维研究

Three-dimensional reconstruction reveals the correlation between the extent of alveolar clefts and secondary nasal deformity in adults

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