The Clinical Efficacy And Psychological Evaluation Of The Autologous Ear Cartilage Transplantation In Correction Of Preschool Children Unilateral Cleft Lip Nasal Deformity

Objective:In this study,Achenbach's Child Behavior Check-List(CBCL)was used to evaluate the psychological problems of pre-school child patients(5-6 years old)with unilateral cleft lip nasal deformity,so as to provide theoretical basis for surgical treatment of pre-school child patients with unilateral cleft lip nasal deformity,study and analyze the clinical efficacy and psychological influence of autogenous ear cartilage graft in the correction of unilateral cleft lip nasal deformity,and further improve the systematic treatment of cleft lip nasal deformity.First part Method:The Achenbach's Child Behavior Check-List was used to study 30 pre-school child patients with unilateral cleft lip nasal deformity who were admitted into the plastic surgery of the people's Hospital Affiliated to Nanchang University from March2018 to March 2019,including 18 boys and 12 girls.The domestic normal model group was used as the control group for comparative analysis.The scale was completed by their parents.By comparing the difference in scores of the two groups,the psychological and behavioral characteristics of pre-school child patients with unilateral cleft lip nasal deformity were analyzed.Results:The detection rate of behavior problems in 30 pre-school child patients with unilateral cleft lip nose deformity was 53.33%,among which the detection rate was61.11% in boys and 41.67% in girls.There was no significant difference between the detection rate and gender(P > 0.05).The detection rate of each behavioral problem factor was 3.3%-26.7%.The top three abnormal behavior factors in boys were as follows: bad communication,hyperactivity and discipline violation;the top threeabnormal behavior factors of girls were as follows: social withdrawal,depression and discipline violation.By comparing the scores of each behavioral problem factor with the domestic normal model,there were statistically significant differences in schizophreniform,bad communication,compulsion,hyperactivity,aggression,discipline violation between boys and normal model(P < 0.05),and statistically significant differences in depression,social withdrawal,aggression,discipline violation and sexual problems between girls and normal model(P < 0.05).Conclusion:1.The detection rate of behavioral problems in pre-school child patients with unilateral nose deformity was significantly higher than that in normal children,and there was no significant correlation between the detection rate and gender.2.The main behavioral problems of pre-school child patients with unilateral cleft lip nose deformity include bad communication,hyperactivity and discipline violation;the main behavioral problems in girls include social withdrawal,depression and discipline violation.Second part Method:12 pre-school child patients with unilateral cleft lip nose deformity who were admitted into the plastic surgery of the people's Hospital Affiliated to Nanchang University and underwent surgical treatment from March 2018 to March 2019 were selected and taken as research objects,including 7 boys and 5 girls.Autogenous ear cartilage graft was used for the correction of nose deformity.The nasal photos and the results of Achenbach's Child Behavior Check-List were collected before operation,6months after operation and 1 year after operation,respectively.The clinical efficacy and psychological behavior changes were analyzed by Asher-McDade 5-point evaluation system and the measurement and evaluation indexes of unilateral cleft lip and nose deformity in West China Stomatological Hospital before operation,6months after operation and 1 year after operation.Results:There were significant improvement in the nostril morphology,contour of nasal tip,height of columella nasi and symmetry of ala nasi at 6 months after operation,and the differences in the scores of the above indexes were statistically significant at 6months after surgery compared with that before surgery(P < 0.05),and there was no statistically significant difference at 1 year after operation compared with that at 6months after operation(P > 0.05).There were significant improvement in the parameters of nasal tip symmetry,columella nasi symmetry,basis nasi symmetry and leaning angle of ala nasi base angle in 6 months after operation,and the differences in the scores of the above indexes were statistically significant at 6 months after surgery compared with that before surgery(P < 0.05),and there was no statistically significant difference at 1 year after operation compared with that at 6 months after operation(P > 0.05).The detection rate at 6 months and 1 year after operation decreased significantly compared with that before operation,and the detection rate at1 year after operation decreased more obviously,but it was still higher than the domestic normal model.Conclusion:1.Autogenous ear cartilage graft in the correction of unilateral cleft lip nose deformity can effectively improve the short columella nasi,nasal tip deviation and ala nasi asymmetry.2.The correction of cleft lip nose deformity can reduce the detection rate of behavior problems,but it is higher than the domestic normal model.Parents and teachers should pay attention to psychological education and counseling in the later stage.3.After anterior ear cartilage excision in pre-school child patients,long term follow-up is needed for posterior auricle development and development of nasal cartilage after transplantation.