双侧唇裂或唇腭裂修复后口哨畸形的分级与修复

目的 对双侧唇裂或唇腭裂修复后口哨畸形的严重程度进行分级。方法 将我院136例双侧唇裂或双侧唇腭裂术后上唇口哨畸形患者作为研究对象，观察上颌前门齿牙冠及相应牙龈暴露的程度将口哨畸形分为Ⅳ级。Ⅰ级： 牙冠显露1／2；Ⅱ级： 牙冠全显露或 牙冠全显露伴 显露近中纵行牙冠1／2—2／3；Ⅲ级： 牙冠全显露和附丽龈显露1／2或 牙冠全显露伴附丽龈显露1／2及 牙冠显露2／3以上；Ⅳ级： 牙冠及相应牙龈全显露伴 近中牙冠纵显露2／3以上。口哨畸形严重程度与双侧唇裂或唇腭裂修复术式的关系一并进行分析。结果 口哨畸形Ⅰ级者60例，占44．2％；Ⅱ级者47例，占34．5％；Ⅲ级者16例，占11．8％；Ⅳ级者13例，占9．5％。结果 显示Ⅰ级和Ⅱ级口哨畸形明显多于Ⅲ级与Ⅳ级，前者为后者的3．7倍。结论 对双侧唇裂或唇腭裂修复后口哨畸形的分级具有良好的临床参考价值，为修复上唇口哨畸形选择修复方法提供了客观依据。

Classification and repairing investigation of the whistling deformities in the patients with bilateral cleft lip or bilateral cleft lip and cleft palate after primary cleft lip repair

OBJECTIVE: To classify the whistling deformities of the patients with bilateral cleft lip or bilateral cleft lip and cleft palate after primary cleft lip repair. METHODS: According to exposure degrees of the gum and the crown of the anterior upper incisors, 136 patients with whistling deformities after primary repair of bilateral cleft lip at the Department of Oral and Maxillofacial Surgery of Xiang Ya Hospital, Central South University were examined and the whistling deformities were classified into four grades. Grade I: the crowns of the left and the right upper incisors were exposed about one-second. Grade II: the whole crowns of the upper incisors were exposed or plus the exposure of the crowns of medial sagittal portion of the left and the right upper lateral incisors. Grade III: the whole crowns of two upper incisors and one-second of the attached gum of two upper incisors or the crowns and one-second of attached gum of the two upper incisors with over two-third of transverse crowns of the lateral incisors were exposed. Grade IV: the crowns and corresponding attached gum of the upper incisors and over two-third of medial sagittal crowns of the upper lateral incisors were exposed. The relation between the degrees of the whistling deformities and the primary procedures of the bilateral cleft lip or the bilateral cleft lip and cleft palate was analyzed. RESULTS: Sixty patients (44.2 percent) had grade I whistling deformities; forty-seven patients (34.5 percent) were Grade II; 16 patients (11.8 percent) were Grade III; 13 cases (9.5 percent) were Grade IV. The results showed that grade I and grade II whistling deformities were obviously more (about 3.7 times) than grade IlI and grade IV whistling deformities. CONCLUSIONS: Classification of whistling deformities provided the objective basis for the selection of operation techniques of cleft lip.