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唇腭裂患者常伴有不同程度的颌骨畸形,需要进行正颌外科治疗,手术方法包括常规正颌外科手术和上颌骨牵引成骨术。常规正颌外科手术最常用的是Le Fort Ⅰ型截骨术,适用于轻至中度的上颌后缩畸形,有时还需要配合双侧下颌升支矢状劈开截骨术(BSSRO)和颏成形术,以进一步改善面型和咬合关系。上颌骨牵引成骨术可采用外置式或内置式牵引器进行,截骨线可根据治疗需要采用Le Fort Ⅰ型截骨线或上颌前部截骨线。正颌外科和牵引成骨术各有其优点和局限性,如何选择合适的治疗方案应综合分析患者病情及医生临床经验,并与患者充分沟通,才能取得良好的矫治效果。

Correction of jaw deformities in cleft lip and palate patients by orthognathic surgery

Cleft lip and palate（CLP） patients always have some degree of jaw deformities,which need to be corrected by orthognathic surgery.The surgical techniques include traditional orthognathic surgical approach and maxillary distraction osteogenesis（DO）.Le Fort Ⅰosteotomy,the most widely used surgical approach,is applicable to light and moderated maxillary hypoplasia,which often need to have bilateral sagittal split ramus osteotomy（BSSRO） and genioplasty at the same time to improve the aesthetic result and occlusion.The Le Fort Ⅰmaxillary DO or anterior maxillary segmental distraction can be performed with external or internal distraction devices depending on the treatment objective.The traditional orthognathic surgical approach and maxillary DO all have their strong points and limitations.In order to get a good clinical effect,the doctor should have overall consideration of his own clinical experience and the patient＇s deformity,and thoroughly discuss with the patients to make a reasonable treatment plan.