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唇腭裂患者常伴有不同程度的颌骨畸形,需要进行正颌外科治疗,手术方法包括常规正颌外科手术和上颌骨牵引成骨术。常规正颌外科手术最常用的是Le Fort Ⅰ型截骨术,适用于轻至中度的上颌后缩畸形,有时还需要配合双侧下颌升支矢状劈开截骨术(BSSRO)和颏成形术,以进一步改善面型和咬合关系。上颌骨牵引成骨术可采用外置式或内置式牵引器进行,截骨线可根据治疗需要采用Le Fort Ⅰ型截骨线或上颌前部截骨线。正颌外科和牵引成骨术各有其优点和局限性,如何选择合适的治疗方案应综合分析患者病情及医生临床经验,并与患者充分沟通,才能取得良好的矫治效果。
Patients with cleft lip and palate often accompanied by varying degrees of jaw deformity, the need for orthognathic surgery, surgical methods include conventional orthognathic surgery and maxillary distraction osteosynthesis. Conventional orthognathic surgery is the most commonly used Le Fort type Ⅰ osteotomy for mild to moderate maxillary deformity, and sometimes need to cooperate with bilateral mandibular ascending sagittal split osteotomy (BSSRO) and the chin Plasty to further improve the facial and occlusal relationship. Maxillary traction osteosynthesis can be used external or internal retractor, osteotomy line can be used according to the needs of the treatment of Le Fort Ⅰ type or maxillary anterior osteotomy line. Orthognathic surgery and traction osteosynthesis have their own advantages and limitations, how to choose the appropriate treatment program should be a comprehensive analysis of the patient’s condition and the clinical experience of doctors and patients with full communication, in order to achieve good correction effect.