Facial and Dental Arch Growth Following Palatal Surgery

描述：唇腭裂的发病率约为1/750，是最常见的先天性畸形之一。手术修复腭裂的主要目标是构建一个能够支持正常非鼻音说话而不损害面部或牙弓生长的腭咽闭合口。患有未修复唇腭裂的成年人很少有面中部凹陷，这是在婴儿时期修复过唇腭裂的成年人的特征。与手术相关的因素可能是面中部生长障碍的主要原因。佛罗里达大学与巴西宝鲁市圣保罗大学合作，提议进行一项纵向研究，以确定6至10岁出生时患有完全性单侧唇腭裂的儿童，其面部和/或牙弓关系是否因修复唇腭裂所使用的外科技术而不同，和/或因其接受腭部手术时的年龄而不同。这项研究建议将目前在NIDCR赞助的一项正在进行的研究中的475名患者纳入其中，在这项研究中，正在评估相对于受试者所接受的外科技术的语音和腭咽闭合结果测量。受试者被随机分配到唇部手术(Spina与Millard技术)、腭部手术(von Langenbeck与Furlow手术)和腭部修复年龄(9-12个月与15-18个月)。这项拟议的研究将提供在这一庞大的患者群体中确定上颌生长和牙弓关系的数据，由此得出结论，即Millard或Spina唇部修复与von Langenbeck腭部成形术或双对置Z成形术对面部和牙弓生长的相对重要性。这项研究的第二部分将是对语音腭咽闭合功能的长期跟踪。

DESCRIPTION: The incidence of cleft lip/palate is approximately 1/750, making it one of the most common congenital malformations. The primary goal in surgically repairing the palatal cleft is to construct a velopharyngeal port capable of supporting normal non-nasal speech without impairing growth of the face or Dental arches. Adults with unrepaired cleft lip and palate rarely have the recessed midface that too often characterizes the profile of adults whose cleft lip and palate have been repaired in infancy. Factors associated with the surgery are likely the major cause of midface growth disturbance. The University of Florida, in collaboration with the University of Sao Paulo, Bauru, Brazil, is proposing a longitudinal study to determine whether children between 6 and 10 years of age, born with complete unilateral cleft lip and palate, have different facial and/or Dental arch relationships as a function of the surgical techniques used in repairing their lip and/or palate, and/or as a function of their age when they received palatal surgery. This study proposes to enroll the entire patient pool of 475 patients who currently are subjects in an ongoing NIDCR sponsored study in which speech and velopharyngeal outcome measures are being assessed relative to the surgical techniques subjects underwent. Subjects were randomly assigned for lip surgery (Spina vs. Millard technique), palatal surgery (von Langenbeck vs. Furlow procedure), and age of palatal repair (9-12 months vs. 15-18 months). The proposed study will provide data defining the maxillary growth and Dental arch relationships in this very large group of patients, from which conclusions should be possible regarding the relative importance of the Millard or Spina lip repair and the von Langenbeck palatoplasty or the double opposing z-plasty palate repair on facial and Dental arch growth. A secondary part of the study will be a long-term follow-up of velopharyngeal function for speech.