Functional Outcomes of Cleft Lip Surgery

描述：本申请是对NOT-OD-09-058的响应，标题为“NIH宣布恢复法案资金可用于竞争性修订申请”。该应用程序与NIDCR R01基金(DE13814)有关，题为“唇裂手术的功能结果”，其目标是将面部功能(运动)和形态的分析扩展到出生时患有唇裂的婴儿(&lt；6个月)。目前，初次或初次唇部修复后的手术结果差异很大。许多患者需要额外的唇部“修整”手术。在父母赠款中，开发了一些方法来客观地确定5至21岁患者翻修手术后患者特定口周区域的损伤和毁容。对于外科医生来说，在首次手术修复唇裂缺损之前了解周围区的功能能力，以便更好地了解修复的生物学效应，从而获得信息以改善手术结果，限制额外手术的需要，将是非常有价值的。我们将探索使用父母补助金中开发的新方法来评估一组唇裂婴儿的面部软组织功能特征，这些婴儿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，并将在类似的时间点进行测试。申请的具体目标如下。1)收集一组出生时唇裂(伴有或不伴有唇裂)的婴儿在初次唇裂修复前后的3D动态和静态面部图像，以及一组年龄和性别匹配的非唇裂对照婴儿的面部图像。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；以及3)探索使用初步分析来确定唇裂婴儿和非唇裂婴儿以及唇裂婴儿初级唇修补术前后面部功能和形态的差异。 公共卫生相关性：唇裂患者初次或初次唇部修复后的美容效果往往有很大的变数。许多患者仍有明显的面部残疾，可能需要进行额外的“修复”手术。在家长资助中，我们开发了一些方法和分析，以客观量化5至21岁患者的面部形态和运动特征。此应用程序的目的是应用我们的方法并探索分析，以评估6个月大婴儿早期存在的动态面部运动和静态面部形态，并确定该形态如何受到影响，以及初级嘴唇手术后面部运动是否仍然明显。这些信息可以帮助确定需要在多早的年龄获得纵向观察，以比较治疗干预方法。

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.