影响单侧唇裂鼻畸形二期整复主观评价结果的鼻测量指标探究
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摘要
目的为了明确影响主观评价单侧唇裂鼻畸形二期整复效果的客观测量指标,进一步改善唇裂鼻畸形整复的治疗水平。方法选取实施过单侧唇裂鼻畸形二期整复患者80名,一方面通过评价者采用Asher-Mcdade主观评价体系对其仰位照片中鼻外形进行5分制评价;另一方面通过仰位照片的客观测量记录每名患者的鼻外形参数。利用多水平模型分析,探究主观评价结果和客观测量参数间的相关性。结果多水平模型分析结果显示:在鼻部5个区域内的测量参数中,仅有鼻尖处参数和鼻小柱长度参数在不同主观评价等级间的差异均具有统计学意义。结论鼻尖偏斜参数和鼻小柱长度参数可作为主观评价等级的预测性指标,而术后鼻翼外凸角、鼻翼基脚内倾角和鼻底宽度参数与主观评价结果没有明显相关性。
Objective To determine objective measurements affecting the subjective evaluation of the secondary reconstruction of unilateral cleft lip nasal deformity and further enhance unilateral cleft lip deformity results. Methods Eighty patients treated with secondary cleft rhinoplasty were enrolled. The study used the Asher-Mcdade subjective evaluation system to rate nasal appearance based on basilar view photographs to measure and record nose shape parameters.Correlation between subjective evaluation results and objective measurement parameters was investigated using multilevel model analysis. Results Multilevel model analysis results showed that among five measurements on nasal parameters,statistically significant differences were observed only for nasal tip and columellar length between subjective evaluation and objective measurements. Conclusion Tip deviation and columellar length parameters could be used as prognostic indicators for grading subjective evaluation, whereas post-operative nasal alar convex angle, mesial inclination of ala, and nasal floor width parameters showed no significant correlation.
Objective To determine objective measurements affecting the subjective evaluation of the secondary reconstruction of unilateral cleft lip nasal deformity and further enhance unilateral cleft lip deformity results. Methods Eighty patients treated with secondary cleft rhinoplasty were enrolled. The study used the Asher-Mcdade subjective evaluation system to rate nasal appearance based on basilar view photographs to measure and record nose shape parameters.Correlation between subjective evaluation results and objective measurement parameters was investigated using multilevel model analysis. Results Multilevel model analysis results showed that among five measurements on nasal parameters,statistically significant differences were observed only for nasal tip and columellar length between subjective evaluation and objective measurements. Conclusion Tip deviation and columellar length parameters could be used as prognostic indicators for grading subjective evaluation, whereas post-operative nasal alar convex angle, mesial inclination of ala, and nasal floor width parameters showed no significant correlation.
引文
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[8]Mani M,Reiser E,Andlin-Sobocki A,et al.Factors related to quality of life and satisfaction with nasal appearance in patients treated for unilateral cleft lip and palate[J].Cleft Palate Craniofac J,2013,50(4):432-439.
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[10]Mercado A,Russell K,Hathaway R,et al.The Americleft study:an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 4.Nasolabial aesthetics[J].Cleft Palate Craniofac J,2011,48(3):259-264.
[11]Nagy K,Mommaerts MY.Analysis of the cleft-lip nose in submental-vertical view,PartⅠ-reliability of a new measurement instrument[J].J Craniomaxillofac Surg,2007,35(6/7):265-277.
[12]He X,Shi B,Kamdar M,et al.Development of a method for rating nasal appearance after cleft lip repair[J].J Plast Reconstr Aesthet Surg,2009,62(11):1437-1441.
[13]Rubin MS,Lowe KM,Clouston S,et al.Basal view reference photographs for nasolabial appearance rating in unilateral cleft lip and palate[J].J Craniofac Surg,2015,26(5):1548-1550.
[14]Eliason MJ,Hardin MA,Olin WH.Factors that influence ratings of facial appearance for children with cleft lip and palate[J].Cleft Palate Craniofac J,1991,28(2):190-194.
[15]Zhu S,Jayaraman J,Khambay B.Evaluation of facial appearance in patients with cleft lip and palate by laypeople and professionals:a systematic literature review[J].Cleft Palate Craniofac J,2016,53(2):187-196.
[16]Russell KA,Orthod D,Tompson B,et al.Correlation between facial morphology and esthetics in patients with repaired complete unilateral cleft lip and palate[J].Cleft Palate Craniofac J,2009,46(3):319-325.
[17]Fisher DM,Tse R,Marcus JR.Objective measurements for grading the primary unilateral cleft lip nasal deformity[J].Plast Reconstr Surg,2008,122(3):874-880.
[18]He X,Li H,Shao Y,et al.Objective measurements for grading the nasal esthetics on Basal view in individuals with secondary cleft nasal deformity[J].Cleft Palate Craniofac J,2015,52(1):66-69.
[19]Gassling V,Koos B,Birkenfeld F,et al.Secondary cleft nose rhinoplasty:subjective and objective outcome evaluation[J].J Craniomaxillofac Surg,2015,43(9):1855-1862.
[20]Power SM,Matic DB.Critical analysis of consecutive unilateral cleft lip repairs:determining ideal sample size[J].Cleft Palate Craniofac J,2013,50(2):144-149.
[21]Meyer-Marcotty P,Alpers GW,Gerdes AB,et al.Impact of facial asymmetry in visual perception:a 3-dimensional data analysis[J].Am J Orthod Dentofacial Orthop,2010,137(2):168.e1-168.e8.
[2]Guyuron B.MOC-PS(SM)CME article:late cleft lip nasal deformity[J].Plast Reconstr Surg,2008,121(4Suppl):1-11.
[3]Zbar RI,Canady JW.An evidence-based approach to secondary cleft lip nasal deformity[J].Plast Reconstr Surg,2011,127(2):905-909.
[4]Henry C,Samson T,Mackay D.Evidence-based medicine:the cleft lip nasal deformity[J].Plast Reconstr Surg,2014,133(5):1276-1288.
[5]Sharma VP,Bella H,Cadier MM,et al.Outcomes in facial aesthetics in cleft lip and palate surgery:a systematic review[J].J Plast Reconstr Aesthet Surg,2012,65(9):1233-1245.
[6]Asher-McDade C,Brattstr?m V,Dahl E,et al.A sixcenter international study of treatment outcome in patients with clefts of the lip and palate:Part 4.Assessment of nasolabial appearance[J].Cleft Palate Craniofac J,1992,29(5):409-12.
[7]Kuijpers-Jagtman AM,Nollet PJ,Semb G,et al.Reference photographs for nasolabial appearance rating in unilateral cleft lip and palate[J].J Craniofac Surg,2009,20(Suppl 2):1683-1686.
[8]Mani M,Reiser E,Andlin-Sobocki A,et al.Factors related to quality of life and satisfaction with nasal appearance in patients treated for unilateral cleft lip and palate[J].Cleft Palate Craniofac J,2013,50(4):432-439.
[9]Pawar SS,Wang TD.Secondary cleft rhinoplasty[J].JAMA Facial Plast Surg,2014,16(1):58-63.
[10]Mercado A,Russell K,Hathaway R,et al.The Americleft study:an inter-center study of treatment outcomes for patients with unilateral cleft lip and palate part 4.Nasolabial aesthetics[J].Cleft Palate Craniofac J,2011,48(3):259-264.
[11]Nagy K,Mommaerts MY.Analysis of the cleft-lip nose in submental-vertical view,PartⅠ-reliability of a new measurement instrument[J].J Craniomaxillofac Surg,2007,35(6/7):265-277.
[12]He X,Shi B,Kamdar M,et al.Development of a method for rating nasal appearance after cleft lip repair[J].J Plast Reconstr Aesthet Surg,2009,62(11):1437-1441.
[13]Rubin MS,Lowe KM,Clouston S,et al.Basal view reference photographs for nasolabial appearance rating in unilateral cleft lip and palate[J].J Craniofac Surg,2015,26(5):1548-1550.
[14]Eliason MJ,Hardin MA,Olin WH.Factors that influence ratings of facial appearance for children with cleft lip and palate[J].Cleft Palate Craniofac J,1991,28(2):190-194.
[15]Zhu S,Jayaraman J,Khambay B.Evaluation of facial appearance in patients with cleft lip and palate by laypeople and professionals:a systematic literature review[J].Cleft Palate Craniofac J,2016,53(2):187-196.
[16]Russell KA,Orthod D,Tompson B,et al.Correlation between facial morphology and esthetics in patients with repaired complete unilateral cleft lip and palate[J].Cleft Palate Craniofac J,2009,46(3):319-325.
[17]Fisher DM,Tse R,Marcus JR.Objective measurements for grading the primary unilateral cleft lip nasal deformity[J].Plast Reconstr Surg,2008,122(3):874-880.
[18]He X,Li H,Shao Y,et al.Objective measurements for grading the nasal esthetics on Basal view in individuals with secondary cleft nasal deformity[J].Cleft Palate Craniofac J,2015,52(1):66-69.
[19]Gassling V,Koos B,Birkenfeld F,et al.Secondary cleft nose rhinoplasty:subjective and objective outcome evaluation[J].J Craniomaxillofac Surg,2015,43(9):1855-1862.
[20]Power SM,Matic DB.Critical analysis of consecutive unilateral cleft lip repairs:determining ideal sample size[J].Cleft Palate Craniofac J,2013,50(2):144-149.
[21]Meyer-Marcotty P,Alpers GW,Gerdes AB,et al.Impact of facial asymmetry in visual perception:a 3-dimensional data analysis[J].Am J Orthod Dentofacial Orthop,2010,137(2):168.e1-168.e8.