牙槽突裂植骨术后鼻外形的改变

目的：通过比较单侧牙槽突裂植骨手术前后鼻外形的变化,评价牙槽突裂植骨术在鼻畸形矫治中的作用。方法：通过人体学测量25例单侧牙槽突裂患者术前、术后即刻及随访6个月的外鼻形态,主要测量指标为健、患侧鼻孔宽度和高度,鼻翼基底宽度及两侧鼻翼基底连线与内眦连线的夹角,应用SPSS18.0软件包,对测得的数据进行配对t检验。结果：25例患者行牙槽突裂植骨手术后患侧鼻孔宽度为（11.61±2.18）mm,大于术前的（10.28±1.83）mm;高度为（4.52±1.19）mm,小于术前的（5.81±1.18）mm;患侧鼻翼基底均高于术前,与术前相比有显著差异（P〈0.01）。随访6个月后,虽形态有向术前回复的倾向,与术前相比仍有显著差异（P〈0.01）。结论：牙槽突裂植骨术后鼻翼基底的变化是植骨成功与否的一个重要指标,适量的超充填可弥补术后骨质吸收,为以后的鼻畸形整复提供一个对称的基底。牙槽突裂植骨后,鼻孔宽度和高度均有变化,故不主张在牙槽突裂植骨同期或之前行鼻畸形整复术。

Comparative study of nasal profile before and after alveolar bone grafting in patients with unilateral cleft lip and palate

PURPOSE：Secondary bone grafting plays an important role in the multimodal therapy of patients with clefts of the lip,alveola,and palate.A comparative study of nasal profile before and after alveolar bone grafting was undertaken in unilateral cleft patients to evaluate the timing of operation and importance to the rhinoplasty.METHODS：Thirty-eight patients with unilateral cleft lip and palate（23 males,15 females） were included in this study.Their ages ranged from 10 to 18 years（average age,13.3 years）.All patients underwent secondary bone grafting under general aneasthesia.Preoperative,postoperative and follow-up（6 months）comparative measurements included nostril width and nostril height in both cleft side and non-cleft side,the width of alar base,the angle of alar base.The data was analyzed with SPSS18.0 software package.RESULTS：Twenty-nine cases were followed up for 6 months after operation,4 cases showed failure with the amount of bone loss above 1/2.25 cases were included for the investigation.Postoperative nostril width of cleft side was increased,the nostril height of cleft side was decreased,the deference was significant（P〈0.01）.6-month postoperative measurement results were inclined to pre-operation,but the difference was still significant.CONCLUSIONS：This study indicates that the change of nasal profile after alveolar bone grafting is obvious,it is unwise for patients to receive rhinoplasty before bone grafting or take the operations at the same time.