三维测量分析单侧完全性唇腭裂术后成年患者的上颌骨形态

目的:探讨单侧完全性唇腭裂术后成年患者的上颌骨形态特征.方法:应用螺旋CT采集30例单侧完全性唇腭裂术后成年患者上颌骨数据,应用SimPlant11.04软件对数据进行三维重建、定点,建立三维坐标系,验证标记点的可重复性,测量标记点到三维坐标平面的距离.应用SAS6.12软件包对数据进行统计学分析.结果:7个居中的标记点中,A、ANS显著偏向健侧(P＜0.01);14对患健侧标记点的非对称率(Q)显示,INM’与INM 、SNM’与SNM、SPr’与SPr在到矢状面S的距离存在明显不对称畸形,而其余多数点在三维方向上无不对称畸形;患者上颌骨与正常人的主要不同是在前后方向上存在发育不足,患侧上颌骨错位较健侧明显.结论:应用螺旋CT及SimPlant 11.04软件三维测量上颌骨形态的方法,能够精确测量各标记点到坐标的三维距离,可用于评估患者患、健侧上颌骨的畸形程度.

Three-dimensional measurement and analysis of maxillary morphology in postoperative adult-patients withunilateral complete cleft lip and palate

PURPOSE： To use spiral CT aided with SimPlantl 1.04 software to 3-d reconstruct, measure and analyze the malformed maxillae in postoperative adult patients with unilateral complete cleft lip and palate. METHODS： 30 maxillae of adult patients（17 men, 13 women ,mean age was 19.07 years） who underwent repair of unilateral complete cleft lip and palate were scanned and three-dimensionally reconstructed 35 landmarks were marked,the reproducibility of the landmarks was confirmed and the distances between landmarks and the 3-D coordinate system was measured and analyzed with spiral CT aided with SimHantll.04. SAS 6.12 software package was used for statistical analysis. RESULTS： There was perfect reproducibility for all 35 landmarks （P〉0.05）. Mean distances and standard deviations from patients＇ landmarks to three-dimensional coordinate planes were gained. Among 7 centered landmarks, A and ANS significantly deviated to noncleft side （P〈0.01）.The asymmetric ratio between cleft sides and noneleft sides in symmetric landmarks demonstrated that there were remarkable asymmetric deformity at the distance to coordinate sagittal plane S between INM＇ -INM, SNM＇-SNM and SPr＇-SPr landmarks. However, there was no asymmetric deformity in three- dimensional directions among MA＇-MA, SoF＇-SoF and LPAC-LPA landmarks in infraorbital region and piriform aperture peritreme. The data showed that the cleft sides were hypoplastic compared with the noneleft sides as well as patients＇ maxillae compared with normal adults, especially in posterior-anterior direction. CONCLUSION： The method of measuring maxillary morphology by spiral CT aided with SimPlant 11.04 software could precisely measure the distances from landmarks to 3-D coordinate system, which could be used for evaluating maxillary deformity between cleft side andnoncleft side of adults＇ patients＇ maxilla before operation. Supported by Shanghai Leading Academic Discipline Project （S30206）.