Functional Outcomes of Cleft Lip Surgery

描述：此申请是对no - od -09-058的回应，标题为“NIH宣布竞争性修订申请恢复法案基金的可用性”。这项申请与NIDCR R01拨款（DE13814）有关，标题为“唇裂手术的功能结果”，目的是将面部功能（运动）和形态的分析扩展到出生时唇裂的婴儿（小于6个月）。目前，初次或初次唇修复后的手术结果是高度可变的。许多患者需要额外的唇部“修复”手术。在父母的资助下，制定了客观确定5至21岁患者翻修手术后患者特异性环周区域损伤和毁容的方法。对于外科医生来说，在进行唇裂缺损的初始修复前，了解环口区域的功能，可以更好地了解修复的生物学效应，从而获得改善手术效果的信息，减少额外手术的需要，具有重要的价值。我们将探索在父母资助中开发的新措施的使用，用于评估一组唇裂婴儿的面部软组织功能特征，并在初次唇部手术前后进行纵向跟踪和测试。第二组年龄匹配的非唇裂婴儿将作为对照，在相似的时间点进行测试。该应用程序的具体目的如下。1)采集一组先天性唇裂（伴或不伴唇裂）患儿唇部一期修复前后的三维动态和静态面部图像；还有一组年龄和性别匹配的非唇裂控制组婴儿。2)开发和完善适用于面部残疾婴儿的面部功能和形态的客观测量方法；3)探索利用初步分析来确定唇裂婴儿和非唇裂婴儿面部功能和形态的差异；对于那些唇裂的婴儿，在唇部修复前后。

DESCRIPTION: This application is in response to NOT-OD-09-058, titled "NIH announces the availability of Recovery Act Funds for Competitive Revision Applications". The goal of this application, which is related to an NIDCR R01 grant (DE13814) titled "Functional Outcomes of Cleft Lip Surgery", is to extend the analysis of facial function (movement) and form to babies (< 6 months) born with a cleft lip. Presently, surgical results after an initial or primary lip repair are highly variable. Many patients require additional lip 'revision' surgeries. In the parent grant, approaches were developed to objectively determine patient-specific impairment and disfigurement of the circumoral region for after revision surgeries in patients 5 to 21 years of age. It would be of great value to surgeons to know the functional capability of the circumoral region before the initial surgical repair of the cleft defect so that they may be better informed about the biological effects of the repair, and as a result, gain information to improve the surgical outcome and limit the need for additional surgeries. We will explore the use of novel measures developed in the parent grant for the assessment of facial soft tissue functional characteristics in a group of cleft babies followed longitudinally and tested before and after primary lip surgery. A second group of age-matched, non-cleft babies will serve as controls and will be tested at similar time points. The Specific Aims of the application are as follows. 1) To collect 3D dynamic and static facial images from a group of babies born with a cleft lip (with or without a cleft palate) before and after primary lip repair; and from a group of age- and sex-matched non-cleft control babies. 2) To develop and refine objective measures of facial function and form that will be applicable for babies with facial disability; and 3) To explore the use of preliminary analyses to determine differences in facial function and form between babies with and without a cleft lip; and for those babies with a cleft lip, before and after primary lip repair. PUBLIC HEALTH RELEVANCE: The esthetic results after an initial or primary lip repair in patients with a cleft lip tend to be highly variable. Many patients remain with an obvious facial disability, and may require additional 'revision' surgeries. In the parent grant, we developed methods and analyses to objectively quantify facial form and movement characteristics in patients 5 to 21 years of age. The intent of this application is to apply our methods and explore analyses to assess dynamic facial movements and static facial form that are present in babies at an early age of 6 months, and to determine how the form is affected and whether the facial movement is still apparent after the primary lip surgery. Such information can help determine how early in age longitudinal observations need to be obtained for a comparison of treatment intervention methods.