| Objective:Cleft lip and palate is one of the most common congenital craniofacial diseases.There are well-established therapeutic regimens for it.For example,most babies will have Stage I cleft lip repair during infancy,and after several months and years other orthodontic surgeries will be operated.During this period,most patients will develop secondary nasal deformity due to further growth or inadequate correction of deformity,which will influence not only facial appearance but also nasal function,such as ventilation function、olfactory function and so on.To improve the quality of life for patients,it’s really important for doctors to pay attention to both appearance and function repairment.Therefore,understanding the anatomical deformity of the nose in patients is essential.In our previous study,we found that unequal volume of the two inferior turbinates,deviation of the nasal septum,and reduction of the nasal space on the cleft side are common deformities in patients.Previous studies always used two-dimensional method to do research in these disease.In this paper,Mimics Medical 17.0 and other digital software were used to conduct a three-dimensional measurement of the middle turbinate,inferior turbinate and nasal septal swell body in patients with secondary nasal deformity of unilateral cleft lip.Method:There were 47 unilateral cleft lip patients with secondary nasal deformity being included in the study.The cranial CT of these patients were uploaded into Mimics Medical 17.0 and other digital software.The patients were divided into two groups according to whether they had cleft palate or not.The first group consisted of 27 patients with unilateral cleft lip and palate,and the second group consisted of 2 0 patients with unilateral cleft lip only.We measured the volume of these structures and repeated all these measurements in one month.Then,we evaluated the anatomical structure differences between the cleft and non-cleft side.Calculate the volume difference of nasal structure between cleft side and non-cleft side in these patients and do correlation analysis of these structure in the ipsilateral nasal cavity.Result:1.Measurement results in total patients(1)Inferior turbinate volume:non-cleft side>cleft side,but there was no clear statistical significance.(2)Defined incisive foramen as the boundary,inferior turbinate was divided into anterior and posterior segments,anterior segment volume:non-cleft side>cleft side(p<0.01),posterior segment volume:cleft side>non-cleft side(no statistical significance).(3)Middle turbinate volume:non-cleft side>cleft side(p<0.01).(4)There was no significant difference between volumes of nasal septal swell body on two sides.2.Measurement results in different groups(1)Group 1(patients with unilateral cleft lip and palate):1)Inferior turbinate volume:noncleft side<cleft side,but there was no clear statistical significance.2)Defined incisive foramen as the boundary,inferior turbinate was divided into anterior and posterior segments,anterior segment volume:non-cleft side>cleft side(p<0.01),posterior segment volume:cleft side>non-cleft side(no statistical significance).3)Middle turbinate volume:non-cleft side>cleft side(p<0.01).4)There was no significant difference between volume of nasal septal swell body on two sides。(2)Group 2(patients with unilateral cleft lip):1)Inferior turbinate volume:non-cleft side<cleft side,but there was no clear statistical significance.2)Defined incisive foramen as the boundary,inferior turbinate was divided into anterior and posterior segments,anterior segment volume:non-cleft side>cleft side,posterior segment volume:cleft side>noncleft side(no statistical significance).3)Middle turbinate volume:non-cleft side>cleft side(p<0.01).4)There was no significant difference between volume of nasal septal swell body on two sides.(3)There was no significant correlation of the changes in volume between the inferior turbinate,the middle turbinate and the nasal septal swell body in the ipsilateral nasal cavity.Conclusion:The volume of the middle turbinate and anterior part of inferior turbinate on non-cleft side was significantly larger than that on cleft side.It was considered that due to the deviation of nasal septum,the volume of the middle meatus and the anterior segment of the inferior meatus on non-cleft side were larger than that on cleft side.Because of this,the middle turbinate and the anterior segment of the inferior turbinate had adaptive hyperplasia to maintain the stability of airflow.Perhaps surgical correction of nasal septum deformity and inferior turbinate can be operated at the same time,so as to help patients improve nasal ventilation function after surgery. |
PDF Full Text Request