Successful early neonatal repair of cleft lip within first 8 days of life
Successful early neonatal repair of cleft lip within first 8 days of life
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DOI：
10.1016/j.ijporl.2012.07.031
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发表时间：
2012-11-01
影响因子：
1.5
通讯作者：
Peterka, Miroslav
中科院分区：
文献类型：
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作者：
Borsky, Jiri;Veleminska, Jana;Peterka, Miroslav
目的：对于出生时唇裂的儿童，手术是纠正先天异常的第一步。与通常进行的 3 个月手术相比，据报道，新生儿手术的好处是：伤口愈合非常好、喂养便利以及新生儿时期儿童良好的社交能力。本研究的目的是通过改进的技术对唇腭裂（CLP）早期新生儿进行唇形整形术，以寻求最佳的美学效果，并从定性和定量方面评估手术结果。方法：2005-2008年期间，由同一位外科医生对97例1-8天龄的新生儿进行手术。 Tennison 的原始技术被修改并使用。根据疤痕可见度以及嘴唇和鼻子的形状和对称性来评估手术的美学效果。使用 3D 有限元尺度分析 (FESA) 在单侧 CLP 患者样本中评估唇整形术对上颌节段形成的影响。我们比较了唇部手术前（8 天以下的新生儿）和腭手术前（12 个月大）制作的牙科石膏模型的 3D 模型。结果：只有健康状况良好且无相关先天缺陷的儿童才允许通过手术。无围术期并发症（除少数病例气管插管位置矫正外）。父母很高兴带回一个没有明显唇裂的新生儿。这不仅有利于婴儿喂养，而且对整个家庭产生重要的积极的心理社会影响。唇形整形术的伤口愈合和美容效果非常好。大多数儿童的疤痕几乎不可见，嘴唇和鼻子是对称的。嘴唇闭合后，观察颌部的生长和接近。这一方面也与包括前上颌骨在内的前部门牙发育有关。结论：我们的结果表明，CLP 的早期新生儿唇部手术是一种有前途的技术，具有非常好的美学效果，并对儿童及其家庭产生重要的积极心理影响。 (C) 2012 Elsevier Ireland Ltd. 保留所有权利。
Objective: In the children born with a cleft lip, surgery is the first step in correcting the inborn anomaly. In comparison with usually made 3-month surgery, benefits of the surgery in neonates have been reported: a very good wound healing, feeding facilitation, and good socialization of a child from neonatal age. The aims of the present study were to perform cheiloplasty in early newborns affected by the total cleft lip and palate (CLP) by the technique modified to search for optimum aesthetic result, and to assess the surgery outcome from qualitative and quantitative aspects.Methods: The operations were performed by the same surgeon in 97 neonates 1-8 days old during 2005-2008. The original technique by Tennison was modified and used. Aesthetic outcome of the surgery was evaluated according to scar visibility, and the shape and symmetry of the lip and nose. The effect of cheiloplasty on the formation of the upper jaw segments was evaluated in a sample of unilateral CLP patients using the 3D-finite element scaling analysis (FESA). We compared 3D models of dental plaster casts made prior to lip surgery (in neonates under 8 days of age) and prior to palate surgery (at 12 months of age).Results: Only the children in excellent health state and without an associated inborn defect were allowed to pass the operation. There were no per-operative complications (except the correction of tracheal tube position in several cases). The parents appreciated bringing home a neonate with no visible cleft. This aspect not only facilitated baby feeding, but had important positive psycho-social impact on the whole family. The wound healing and aesthetic effect of the cheiloplasty were very good. The scar was barely visible and lip and nose were symmetric in majority of children. After lip closure, the growth and approximation of jaw segments was observed. This aspect was also associated with incisors development in the anterior portion of the segment including premaxilla.Conclusions: Our results show, that early neonatal lip surgery of CLP is promising technique with very good aesthetic results and important positive psychological impact on the child and its family. (C) 2012 Elsevier Ireland Ltd. All rights reserved.