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回転降下法を用いた片側性完全口唇裂の鼻唇部の左右対称性の評価
[Evaluation of the symmetry in nasolabial area of unilateral complete cleft lip with the method of rotation descent step by step].
PMID: 32524121
抄録
目的:
片側性完全口唇裂（UCCL）の一次修復後の鼻唇部の対称性と安定性を回転降下法を用いて段階的に評価すること。
PURPOSE: To evaluate the symmetry and stability of nasolabial area of unilateral complete cleft lip (UCCL) after primary repair with the method of rotation descent step by step.
方法:
手術を受けたUCCL患者30名を手術前、1週間後、1年後に写真撮影し、alare点(al)、sub alare点(sba)、christa phlitri点(cph)、chelion点(ch)から顔面垂直中線(VML)までの距離を測定し、対t検定により反対側との比較を行った。統計解析はSPSS 19.0ソフトウェアパッケージを用いて行った。
METHODS: Thirty patients with UCCL who were operated on were photographed before, 1 week after and 1 year after surgery, the distances from alare point (al), sub alare point (sba), christa phlitri point (cph) and chelion point (ch) to the facial vertical midline (VML) were measured and compared with the opposite side by paired t test. Statistical analysis was performed with SPSS 19.0 software package.
結果:
術前と術後1週間の間にal, sba, cphに有意差があり(P<0.05)、術前と術後1週間の間にal, sba, chに有意差があった(P<0.05)が、術後1年後にはsba以外に有意差はなかった。術後、VMLからの距離はすべて術前よりも小さくなっていた。術後1週間と1年後の対称率は、sbaを除くすべての点で有意差はなかった。
RESULTS: There were significant differences in al, sba and cph between the cleft side and non-cleft side before(P<0.05) and 1 week after surgery; significant differences were found in al, sba and ch between the affected and unaffected side (P<0.05); but 1 year after surgery, there was no significant difference between the two sides except sba. After surgery, all the distances from VML were less than those before surgery. There was no significant difference in symmetry rate between 1 week and 1 year after surgery for all the points except sba.
結論:
この結果から、段階的に回転降下を行う方法は唇の対称性の再構築に非常に有用であるが、一次修復では鼻の対称性を完全に回復させることはできないことが示された。
CONCLUSIONS: The results indicated that the method of rotation descent step by step is very helpful in reconstruction of lip symmetry, but primary repair can not achieve full recovery of nasal symmetry.