Functional Outcomes of Cleft Lip Surgery

唇裂的初次手术修复对上唇瘢痕和毁容有很大的潜在影响 鼻子需要进一步矫正病人，他们的父母，和手术医生必须决定 唇裂初次矫正后进行二次唇翻修的益处是否大于风险。 直到最近，还缺乏关于翻修手术益处的定量数据， 对于或反对修正手术的建议必然是基于主观的，因此， 变量评价在最初的资助期间，进行了一项非随机临床试验，结果是 * 在制定和描述客观量化成果方面取得重大进展， 唇腭裂患者的修复手术。这样建立的数据库现在是 世界上有广泛的三维面部软组织运动的客观措施， 形态学、唇力、唇感觉和感觉整合功能。这里提出的调查 代表了这项研究的扩展。 因此，这一持续项目的目标如下。1)为了确定外科医生如何使用 新开发的唇功能客观测量方法在决定是否修唇过程中的应用 手术2)建立二次唇修复治疗的“护理参数”标准， 标准化、系统化的主观评价和客观测量。3)去调查那个- 唇翻修手术的远期功能结局。这一信息将通过继续目前的 临床试验，并招募了额外的30名新患者，他们将接受唇部翻修手术。的 中心假设仍然是“虽然当代唇修正手术可以改善唇形， 休息，功能可能进一步受损”。 这项研究将使外科医生能够解决以下结果，并在这样做的过程中提供改进的 患者护理：1）测量初次唇修复后存在的特定功能缺陷; 2）评估 目前的初次和二次唇部手术的有效性; 3）评估唇部修复的长期影响， 口周环境的维持; 4）确定二次唇部手术是否会导致显著的 改善唇部形状和功能; 5）确定是否需要进行额外的手术。在 将来，这些评估可用于确定不同手术技术对唇的效果， 翻修手术

Primary surgical repair of a cleft lip has significant potential for scarring and disfigurement of the upper lip and nose that requires further correction. Patients, their parents, and the operating surgeons must decide whether the benefits of a secondary lip revision following primary correction of a cleft lip outweigh the risks. Until recently, quantitative data on the benefits of revision surgery have been lacking, and the clinical recommendations for or against revision surgery have necessarily been based on subjective and, therefore, variable evaluations. In the initial grant period, a non-randomized clinical trial was conducted that resulted in significant progress towards the development and characterization of objective quantitative outcomes of revision surgery in patients with cleft lip and palate. The database so established is now the only one in the world that has extensive objective measures of three-dimensional facial soft-tissue movement and morphology, lip force, lip sensation, and sensory-integrative function. The investigations proposed here represent an expansion of this research. Thus, the goals of this continuing project are as follows. 1) To determine how surgeons might use the newly-developed objective measures of lip function in the decision-making process for or against lip revision surgery. 2) To establish "parameters of care" criteria for secondary lip revision treatment based on standardized, systematic subjective evaluations, and objective measurements. 3) To investigate the long- term functional outcomes of lip revision surgery. This information will be obtained by continuing the present clinical trial and by enrolling an additional cohort of 30 new patients who will receive lip revision surgery. The central hypothesis continues to be that "although contemporary lip revision surgery may improve lip form at rest, function may be further impaired". This research will enable surgeons to address the following outcomes, and in doing so provide improved patient care: 1) measure the specific functional deficits that are present post-primary lip repair; 2) assess the effectiveness of current primary and secondary lip operations; 3) assess the long-term effects of lip repair on the maintenance of the circumoral milieu; 4) determine whether secondary lip surgery results in significant improvement in lip form and function; and 5) determine whether additional surgery is really warranted. In the future, these evaluations can be used to determine the outcomes of different surgical techniques forlip- revision surgery.