中国唇腭裂治疗面临的挑战与机遇

我国是目前世界上唇腭裂患者最多的国家之一,每年又有3万左右的新增病例。在我国大部分地区,如何整体提高对唇腭裂患者治疗的效果仍然是一个值得重视的临床课题。本文通过对国内著名口腔医学院校及医疗中心进行问卷调查,对我国唇腭裂治疗的现状进行了研究。作为国内最大的唇腭裂治疗中心之一,愿在此和国内同行一起分享本中心对于唇腭裂序列治疗的经验,并希望能借此提高我国唇腭裂治疗的水平,使更多的唇腭裂患者能够得到专业团队的治疗。     

Anne Marie Kuijpers-Jagtman教授访问北京医科大学

应北京医科大学口腔医学院邀请,荷兰Nijmegen大学正畸科教授,唇腭裂中心主任AnneMarieKuijpers-Jagtman博士于1999年9月8日访问了北京医科大学口腔医学院正畸科并就唇腭裂患者的上颌发育进行了专题讲座。AnneMarieKuijpers-Jagtman教授从事唇腭裂治疗和研究二十多年,经验丰富。她首先简单地介绍了Ni-jmegen大学正畸科及唇腭裂治疗中心的情况,然后就唇腭裂患者上颌骨发育普遍较差的原因发表了看法。唇腭裂患者上颌骨发育问题是受到世界上普遍关注的问题,同时也是唇腭裂治疗中的难点之一。AnneMarieKuijpers-Jagtman教授认为:影响唇腭裂…     

单侧完全性唇腭裂上下牙弓关系评价研究

目的　评价单侧完全性唇腭裂（UCLP）患者上、下颌牙弓关系的协调性,并与亚洲和欧洲几大著名唇腭裂治疗中心的研究结果进行比较,为唇腭裂继发牙牙合畸形的诊断、矫治设计和序列治疗提供依据。方法　回顾性分析2013年3月至2014年3月于青岛大学附属医院口腔正畸科就诊的52例UCLP患者治疗前的记存模型,按照Goslon Yardstick 评价系统和Eurocleft三分类法进行牙弓协调性评价。与中国台湾长庚医院、日本东京大学医院及欧洲6所唇腭裂治疗中心（A～F）的同类研究结果相比较,并进行统计学分析。结果　本中心UCLP患者Goslon Yardstick平均等级为3.75 ± 0.93,Goslon Yardstick等级为4的患者最多,占36.5%,59.6%患者属于差及较差的等级。与台湾长庚医院、东京大学医院及欧洲唇腭裂D治疗中心的结果相接近（P＞0.05）,比其他5所欧洲唇腭裂治疗中心患者的牙弓协调性差（P＜0.05）。结论　UCLP患者上、下牙弓协调性差。青岛大学附属医院接受正畸治疗的UCLP患者,上下牙弓协调性与台湾长庚医院、东京大学医院、欧洲唇腭裂D治疗中心接近,比其他5所欧洲唇腭裂治疗中心牙弓协调性差。     

Prahl-Andersen教授来访

应北京大学口腔医学正畸科的邀请,2002年11月22日,来自荷兰阿姆斯特丹牙科研究中心的Prahl—Andersen教授来我院进行学术交流,并就唇腭裂患者的早期治疗及序列治疗作了独特的专题讲座。 Prahl—Andersen教授在唇腭裂正畸治疗方面有着丰富的临床经验和丰硕的研究成果;作为唇腭裂治疗小组的一名成员,她亦积极致力于唇腭裂患者治疗的推广工作,为改善唇腭裂患者的生存质量而努力至今。     

重视麻醉在唇腭裂整复术中的作用

近20年来,随着各种慈善组织进入我国,开展唇腭裂整复术的医院逐渐增多,提高了国内唇腭裂整复的整体水平。但在普及过程中,也出现了一些问题,尤其是在麻醉方面。本文从唇腭裂患者和婴幼儿的特点及其唇腭裂治疗出发,阐述了麻醉医师在唇腭裂整复中的作用和地位,同时提出了"龟兔赛跑的新理念",强调了团队合作的重要性。作为国内最大的唇腭裂治疗中心之一,愿在此和国内同行一起分享对于唇腭裂治疗的经验,并希望能借此提高我国唇腭裂治疗的水平,使更多的唇腭裂患者能够得到专业唇腭裂和麻醉团队的治疗。     

婴幼儿期唇腭裂患者术前鼻-腭-牙槽骨矫形治疗的研究进展

唇腭裂（cleft lip palate,CLP）患者经过一系列手术后仍存在比较严重的错【牙合】畸形，据统计，唇腭裂患者恒牙期时的错【牙合】畸形发生率为97％，需要正畸治疗。随着人们对唇腭裂先天畸形认识的深入、生活水平的提高和医疗技术的发展，唇腭裂患者的治疗由单一的手术治疗转为序列治疗。唇腭裂序列治疗中婴幼儿期颌骨的术前矫形治疗是唇腭裂序列治疗中最为基础的环节，它有利于唇腭裂患者上颌骨前段的对位、     

术前正畸在婴儿期单侧完全性唇腭裂治疗中的作用

术前正畸在婴儿期单侧完全性唇腭裂治疗中的作用广州市儿童医院口腔科（５１０１２０）邓利琴王洪涛作者对婴儿期单侧完全性唇腭裂的患者进行了术前正畸治疗，通过对术前正畸联合唇腭裂手术与单纯唇腭裂手术的比较，观察术前正畸对完全性唇腭裂治疗的作用，报告如下。材料...     

国家级继续教育学习班通知唇腭裂整复术以及语音治疗学

全国继续教育项目 (编号 :2 0 0 3- 0 8- 0 2 - 0 0 9)上海第二医科大学附属第九人民医院和上海第二医科大学唇腭裂治疗研究中心承担的国家级《唇腭裂整复术以及语音治疗学》继续教育学习班 ,现定于 2 0 0 4年 5月 2 1日至 5月 2 5日在上海举办 ,为期 5天。上课内容 :唇腭裂整复术及进展 ;唇腭裂麻醉特点 ;病理语音学基础 ;唇腭裂患者语音特点及治疗 ;唇腭裂患者序列正畸和正颌外科治疗 ;唇腭裂患者听力和心理等方面内容。课程由长期从事以上课题研究并获各级科技奖励的教授及研究人员主讲 ,本学习班注重理论联系实际 ,内容丰富 ,形式多样 ,…     

国家级继续教育项目——唇腭裂整复术以及语音治疗学学习班通知

上海第二医科大学附属第九人民医院和上海第二医科大学唇腭裂治疗研究中心承担的国家级《唇腭裂整复术以及语音治疗学》继续教育学习班(全国继续教育项目,编号:2003-08-02-009),定于2004年5月21日至25日在上海举办,为期5天。上课内容:唇腭裂整复术及进展;唇腭裂麻醉特点;病理语音学基础;唇腭裂患者语音特点及治疗;唇腭裂患者序列正畸和正颌外科治疗;唇腭裂患者听力和心理等。课程由长期从事以上课题研究并获各级科技奖励的教授及研究人员主讲,注重理论联系实际,内容丰富,形式多样,欢迎参加。招生对象:口腔科,耳鼻咽喉科,整形外科医师,语音治…     

Millard在唇腭裂综合治疗方面的新进展

在美国凡有较高学术水平或较高临床医疗质量的整形外科中心或唇腭裂中心均设有综合治疗组,它由整形外科医师(或颌面外科医师)、正畸医师、语音病理专家、耳、鼻、喉科医师等组成。每一个唇腭裂患者必须经过这个组诊治,随访。在世界著名的整形外科和唇腭裂专家 Millard 所在的整形外科中心,笔者所见到     

Nasolabial appearance in unilateral cleft lip, alveolus and palate: a comparison with Eurocleft.

OBJECTIVE: To evaluate nasolabial appearance of patients with UCLAP treated in Nijmegen and to compare them with those from six other individual centers from the Eurocleft study. Relationships between nasolabial aesthetics, dental arch relationships and cleft width at birth were also investigated. PATIENTS: Children of Caucasian origin with complete UCLAP (n=42 consecutive cases) from the Nijmegen Cleft Palate Unit, The Netherlands. METHODS: Nasolabial appearance was assessed by applying an aesthetic index and subsequently compared with the six-centre Eurocleft study. Cleft width at birth was measured on maxillary plaster casts. RESULTS: The 90% central range for the overall aesthetic rating of the 42 Nijmegen patients is 2.0-3.7 on a scale from 1 to 5 (1=very good nasolabial appearance, 5=very poor nasolabial appearance). With regard to the overall aesthetic rating, Nijmegen showed similar treatment outcomes with Eurocleft centres A, D, E and F. Nijmegen scored significantly better than Eurocleft centre C and significantly worse than Eurocleft centre B (p相似文献   

河南省部分地区唇腭裂患者术后继发畸形调查分析

目的：了解唇裂、腭裂一期手术后继发畸形的情况。并探讨其影响因素及有效的解决方法。方法：采用普查法对河南省部分地区人群进行随访,对唇腭裂患者进行术区照相,根据照片记录手术类型、术后继发畸形情况,将结果进行统计学分析。结果：共随访唇腭裂术后患者2046例。单侧唇裂患者1514例,术后继发畸形1268例,,双侧唇裂患者488例,术后继发畸形466例,腭裂患者446例,术后继发硬腭穿孔及软腭复裂26例。结论：适当选择唇腭裂手术类型,对唇腭裂术后患者进行定期随诊及普查,及时发现、治疗术后继发畸形,对提高唇腭裂手术的治疗效果具有极为重要的意义。     

Management of cleft palate among patients with Pierre Robin sequence

Pierre Robin Sequence (PRS) is a congenital craniofacial anomaly distinguished by the presence of micrognathia, glossoptosis, and upper airway obstruction. Cleft palate occurs in over 3/4 of patients with PRS. The wide U-shape cleft and airway dysfunction create challenges in clinical management. Currently, disputes exist on the treatment protocol and prognosis of cleft palate management among patients with PRS. This review is focused on the deformity features, intervention timing, technique selection, airway support, and outcome evaluation of cleft palate among patients with PRS, aiming to provide reference to further evolution in the management of PRS-related cleft palate.     

乳牙与替牙期唇腭裂患者上颌宽度不足的管控

唇腭裂是颌面部最为常见的先天性发育畸形.许多唇腭裂患者表现为上颌宽度发育不足,合理治疗上颌宽度不足,对于获得理想和稳定的唇腭裂序列治疗效果具有重要意义.正畸治疗是唇腭裂序列治疗的重要组成部分,本文就乳牙与替牙期正畸治疗中针对上颌宽度不足的合理管控进行了论述.     

Submucous clefts of the palate: how likely are they to be symptomatic?

A group of 130 patients with submucous clefts were identified from the records of the University of Pittsburgh Cleft Palate-Craniofacial Center. Many of these patients, 44 percent, remained asymptomatic into adulthood, and none required surgical intervention. A submucous cleft should be repaired in infancy only when feeding problems or unremitting ear disease is observed. The cleft should not be repaired on the theoretical basis of the potential effect of the cleft on the development of communication skills. The development of predictors that will enable professionals' valid management decisions must be developed.     

Comparison of resonance outcomes after pharyngeal flap and furlow double-opposing z-plasty for surgical management of velopharyngeal incompetence.

OBJECTIVE: The purpose of this study was to test the hypothesis that no significant difference exists in the speech outcomes between patients with severe velopharyngeal incompetence (VPI) who receive a pharyngeal flap and patients with less severe VPI who receive a Z-plasty for management of VPI. DESIGN: This retrospective study from 1993 to 2002 included a review of pre- and postoperative perceptual speech and resonance assessments of patients with marginal VPI who received a Furlow double-opposing Z-plasty and patients with VPI who received a pharyngeal flap. SETTING: All patients had surgical management of VPI at the Cleft Palate-Craniofacial Clinic at University of Iowa Hospitals and Clinics. RESULTS: Both groups benefited from surgery with significant reduction in perceived hypernasality (p < .001). Comparison of postoperative assessments indicated no difference between the groups in hypernasality or hyponasality ratings. Neither group had a significant increase in hyponasality. CONCLUSION: Both pharyngeal flap and double-opposing Z-plasty proved equally effective at reducing hypernasality when the selection of the surgical procedures was based on preoperative ratings of perceived hypernasality and evaluation of velopharyngeal physiology. Severity of the VPI is an important factor when considering surgical management of VPI. Thorough preoperative evaluations of patients with VPI are essential in appropriate treatment planning.     

Plaques palatines chez le nourrisson porteur de fente labiomaxillaire

Cleft lip and palate represent a common congenital dysmorphosis that requires multidisciplinary treatment care, from birth to the end of adolescence. The therapeutic calendars, as well as the surgical techniques used, vary from an operational centre to another, just like the resort to presurgical orthopaedic treatment. Today, palatal plates are recommended by some authors and disparaged by others. Several kinds of plates exist: fixed or removable, active or passive, combined or not to an extraoral strapping. After reminding the principal cleft lip and palate classifications, we describe the different kinds of palatal plates and their realisation techniques. Preoperative orthopaedic treatment is of course much debated, but short-, mean- and long-term expected beneficial effects are not the same for all teams. It remains difficult to make allowance between the combined action of surgery, orthopaedic treatment, the extent of dysfunctions, the initial polymorphism of cleft, the growth potentialities different from an individual to another. Considering the variability of the therapeutic protocols from an operational centre to another, it is very difficult today to assess the importance of these presurgical orthopaedic treatments.     

Assessment of patients' level of satisfaction with cleft treatment using the Cleft Evaluation Profile.

OBJECTIVES: Determination of the psychosocial status and assessment of the level of satisfaction in Malaysian cleft palate patients and their parents. DESIGN: Cross-sectional study. PARTICIPANTS AND METHODS: Sixty cleft lip and palate patients (12 to 17 years of age) from Hospital Universiti Sains Malaysia and their parents were selected. The questionnaires used were the Child Interview Schedule, the Parents Interview Schedule, and the Cleft Evaluation Profile (CEP), administered via individual interviews. RESULTS: Patients were teased because of their clefts and felt their self-confidence was affected by the cleft condition. They were frequently teased about cleft-related features such as speech, teeth, and lip appearance. Parents also reported that their children were being teased because of their clefts and that their children's self-confidence was affected by the clefts. Both showed a significant level of satisfaction with the treatment provided by the cleft team. There was no significant difference between the responses of the patients and their parents. The features that were found to be most important for the patients and their parents, in decreasing order of priority, were teeth, nose, lips, and speech. CONCLUSIONS: Cleft lip and/or palate patients were teased because of their clefts, and it affected their self-confidence. The Cleft Evaluation Profile is a reliable and useful tool to assess patients' level of satisfaction with treatment received for cleft lip and/or palate and can identify the types of cleft-related features that are most important for the patients.     

A descriptive epidemiology study of cleft lip and palate in Northern Finland

Objective. The aim of this study was to determine the incidence of cleft lip and/or cleft palate in a population uniquely from Northern Finland. Materials and methods. The records of a total of 214 cleft patients treated between 1998–2011 at the Oulu Cleft Lip and Palate Center at the University of Oulu were assessed on a retrospective basis. Data regarding cleft type, sex and side of cleft was collected and analyzed. Family history of clefting was investigated. Results. Cleft palate (68.7%) was most frequently found, followed by cleft lip and palate (18.7%) and cleft lip with or without alveolus (12.6%). Cleft palate occurred more frequently in females (63.3%) and cleft lip and palate was more frequently found in males (62.5%). The left side was more frequently affected in both male and female patients. Left-sided clefts were observed in 82% of patients compared to right-sided clefts in 18%. A family history of clefting was detected in 20.1% of patients. Conclusion. The incidence of clefts in Northern Finland is higher than the corresponding incidence in other European countries. Cleft palate was the most frequent cleft type and it was more frequent in females. In males, cleft lip and palate was more frequent. The left side was more frequently affected in both genders. One fifth of the patients had a family history of clefts.