单侧唇裂术后继发鼻畸形的影响因素分析

目的：研究单侧唇裂术后继发鼻畸形的影响因素。方法：收集2005年1月—2006年12月就诊于中国医科大学口腔医院的单侧唇裂术后患者150例,拍摄患者正位、侧位和仰位照片,根据鼻尖、鼻翼、鼻小柱、鼻中隔、鼻背和骨组织畸形程度,对150例患者单侧唇裂术后继发鼻畸形的严重程度进行评价,分为轻度、中度、重度组,筛选性别、患侧、年龄、原有唇裂畸形严重程度、唇裂整复术术式、一期鼻整形术、牙槽突裂和上颌骨发育等因素,应用SPSS13.0软件包分析单侧唇裂术后继发鼻畸形形成中的影响因素。结果：鼻畸形严重程度分组符合评价一致率50%以上患者143例,轻度鼻畸形33例,中度鼻畸形65例,重度鼻畸形45例。性别和患侧对唇裂术后继发鼻畸形无显著影响（P〉0.05）,对唇裂术后继发鼻畸形有影响的因素为年龄（P=0.019）、唇裂严重程度（P=0.000）、唇裂整复术式（P=0.000）、一期鼻整形术（P=0.000）、上颌骨发育（P=0.000）和牙槽突裂（P=0.000）。结论：年龄、原有唇裂畸形的严重程度、唇裂术式选择、一期鼻整形术、上颌骨的发育程度及牙槽突裂是唇裂术后鼻畸形的影响因素。二期鼻整形术前,必须去除上述因素的影响,才能获得理想的术后效果。

Study of the influencing factors of the secondary unilateral cleft nasal deformity

PURPOSE： To analyse the influencing factors of the secondary nasal deformity of unilateral cleft lip. METHODS： One hundred and fifty patients who had unilateral cleft lip and visited the Stomatological Hospital of China Medical University were collected from January, 2005 to December, 2006. Pictures of the patients were taken at the frontal position, the lateral position and the face-up position. 150 patients who had secondary nasal deformity of unilateral cleft lip were classified into mild group, moderate group and severe group according to the severity of the deformity of the nasal apex and ala, the nasal column, the nasal septum, the nasal dorsum and the bone, and the following factors were screened out： sex, location, age, severity of cleft lip, method in repair of cleft lip,primary rhinoplasty,growth of maxilla and alveolar cleft. Using Chi-square test in SPSS13.0 software package, the influencing factors of the secondary nasal deformity of unilateral cleft lip were analyzed. RESULTS： There are 143 patients who gained a 50% consensus, 33 patients with mild deformities, 65 patients with moderate deformities, and 45 patients with severe deformities. Sex and location had no influence on secondary nasal deformity（P〉0.05）;age（P=0.019）, severity of cleft lip（P=0.000）, method in repairing of cleft lip（P=0.000）, primary rhinoplasty（P=0.000）, growth of maxilla（P=0.000） and alveolar cleft（P=0.000） had influence on the severity of secondary nasal deformity of unilateral cleft lip. CONCLUSIONS： Age, severity of cleft lip, method in repair of cleft lip , primary rhinoplasty,growth of maxilla and alveolar cleft were the influencing factors of the severity of secondary nasal deformity of unilateral cleft lip. Before secondary rhinoplasty, these factors should be removed to achieve a more ideal result.