口唇・口蓋裂児の頭蓋顎顔面の成長発育についての経年的研究 乳児期から４歳時まで

Abstract

Serial frontal and lateral roentgenocephalograms of 140 infants with cleft lip and/or palate were taken at cheiloplasty, palatoplasty and at four years old at Kyushu University Dental Hospital. The subjects consisted of 36 unilateral cleft lip and alveolus (UCLA), 58 unilateral cleft lip, alveolus and palate (UCLP), 14 bilateral cleft lip, alveolus and palate (BCLP) and 32 isolated cleft palate (CP). Twenty-six dimensions and seven angles were measured on each set of cephalograms. Changes in the measurements were evaluated by ANOVA to characterize the craniofacial growth patterns of each cleft type. Twenty-five male complete UCLP subjects were classified by cluster analysis to investigate the presence of several growth patterns in the same cleft type.The results were as follows:1. Changes in the cranial base length in UCLP were significantly larger than in UCLA.2. Among UCLA, UCLP and BCLP, there was no difference in the changes of maxillary length. Forward growth of the anterior and posterior margins of the maxilla were significantly larger in UCLA than in CLP (UCLP and BCLP). However, there was no difference in the forward growth of the maxilla in UCLP, BCLP and CP.3. The changes of mid-facial height in UCLA were significantly smaller than in CLP. There was no difference in those of UCLP, BCLP and CP. However, when the mid-facial height was separated into upper and lower mid-facial heights, changes of the upper mid-facial height in BCLP were significantly larger, and those of the lower mid-facial height were significantly smaller than in UCLP and CP.4. Differences in changes of the mandible and the posterior maxillary height were not significant in any cleft type.5. Changes in the nasal and maxillary breadth in UCLA were significantly larger than in CLP, and those in CP were also significantly larger than in CLP.6. By cluster analysis, male complete UCLP subjects were classified into three subgroups.Their craniofacial growth patterns were significantly different. It was suggested that all infants with the same cleft type did not necessary follow the same growth pattern.