LIP PRESSURE AFTER MILLARD AND SPINA CLEFT LIP SURGERY

唇腭裂的发病率为1/750，是世界上唇腭裂发病率最高的 常见的先天性畸形。通常情况下，嘴唇的外科闭合 大约在3个月大的时候进行，12-24岁时闭合 月份。唇腭裂手术修复后的上颌 退缩通常成为一种显著的形态特征，而且它已经 长期以来，人们一直认为它是组织疤痕和收缩 在面中部造成畸形的腭部闭合后 成长。然而，越来越多的证据表明，增长受阻可能会 更多地与唇部手术修复有关，而不是与腭部手术有关。 佛罗里达大学(UF)与佛罗里达大学合作 巴西圣保罗(USP)提出了一项为期两年的随机、 一项确定是否采用脊柱和鼻翼联合修复唇部的对照研究 Millard技术会产生不同程度的静息嘴唇压力 对准牙槽和牙齿。脊柱手术通常使用 整个巴西，而米勒德技术通常用于 我们。受试者将从608名单边受试者中随机挑选 唇腭裂婴儿目前正在进行合作 这两个中心正在进行NIDR R01研究。 唇部压力将使用电动压力传感器进行评估。 范围为0到10磅/平方英寸。传感器将被嵌入到 硅胶和弯曲的，以适应前上颌牙槽和 上嘴唇。传感器将连接到一个信号 提供5VDC励磁的调节和指示装置 电压，放大并在数字显示图表上显示输出。 所有200名唇裂患者都将在手术结束时接受静息唇压评估 手术时间及定期安排的术后时间 术后6个月、12个月、18个月和24个月在USP进行评估。前200名 正常对照婴儿将在儿科诊所接受评估 佛罗里达大学。唇压也将在中线进行评估 作为中线的右边和左边。 这项研究代表着一个独特的机会，可以进一步 对两种不同常用手术方式的认识 修复唇裂的技术结果有很大的不同 静息嘴唇对牙槽和牙齿的压力水平。发现 静息唇压与手术技术的差异 和/或裂隙婴儿和正常对照组之间的关系将提供 为随后的面中部生长模式的长期评估奠定了基础。

The incidence of cleft lip/palate is 1/750 making it one of the most common congenital malformations. Typically, surgical closure of the lip is performed around 3 months of age and palatal closure by 12-24 months. Following surgical repair of the lip and palate, maxillary retrusion generally becomes a prominent morphologic feature, and it has long been purported that it is tissue scarring and contracturing following closure of the palate that creates aberrations in midfacial growth. However, there is growing evidence that impaired growth may be related more to surgical repair of the lip than to palatal surgery. The University of Florida (UF) in collaboration with the University of Sao Paulo (USP), Brazil is proposing a two-year prospective randomized, controlled study to determine whether lip repair by the Spina and Millard techniques results in different levels of resting lip pressure against the alveolus and teeth. The Spina procedure is generally used throughout Brazil while the Millard technique is commonly used in the US. Subjects will be randomly selected from a cohort of 608 unilateral cleft lip and palate infants currently being entered into a collaborative NIDR R01 study being conducted by these two centers. Lip pressure will be assessed using an electrical pressure transducer with a range of 0 to 10 psi. The transducer will be embedded in silastic and curved to fit between the anterior maxillary alveolus and the upper lip. The transducer will be connected to a signal conditioning and indicator unit which provides a 5 VDC excitation voltage, amplifies and displays the output on a digital display chart. All 200 cleft lip patients will be assessed for resting lip pressure at the time of surgery and at their regularly scheduled postoperative evaluations at USP (6, 12, 18 and 24 months) following surgery. The 200 normal control infants will be assessed in the pediatric clinics at the University of Florida. Lip pressure will be assessed at midline, as well as right and left of midline. This study represents a unique opportunity to further our understanding of whether two different and commonly used surgical techniques for the repair of cleft lip result in quantifiably different levels of resting lip pressure against the alveolus and teeth. Findings of differences in resting lip pressure relative to surgical technique and/or between the cleft infants and normal controls will provide the basis for subsequent long-term assessment of midfacial growth patterns.