The Classification And Evaluation In Healthy Adults And Patients With Cleft Lip In Pyriform Hole Region By CT Three Dimensional Reconstruction

BackgroundWith the development of computer technology and combines it with CTtechnology,3D reconstruction with the "exact reconstruction of biological model,spatial structure of a full range of display, accuracy and precision" and otheradvantages, and clinicians are more and more imaging in favor of diseaseclassification, diagnosis, treatment and operation mode. Etc. The diagnosis andtreatment of CT3D reconstruction in orthopedic diseases also concern, which isparticularly prominent in maxillofacial diseases.Cleft lip is one of the common congenital disease, because of its special structureand deformity diversity becomes difficult reconstructive operation. At the same timedue to difference in growth, selection and operation level of one stage caused bysecondary lip and nasal deformities after operation, become the key to the follow-uptreatment, the main manifestation of nasal deformity. Provided an opportunity forintroducing3D measurement technique of CT operation for accurate diagnosis of thedisease and the implementation of personalized, lip, nose shape measurement by theattention, but for cleft lip deformity measurement, especially the piriform aperturearea measurement, domestic and foreign scholars seldom reported. ObjectiveTo analysis the characteristic of health adult piriform aperture shape, and makethe medical reference range, and provide imaging reference data of operation and theimplementation of3D bio printer.To analysis the piriform aperture shape of adultpatients with cleft, study the anatomical characteristics and anatomical characteristicof cleft lip futher, Put forward the classification of the piriform aperture deformity toprovide the reference for the clinical treatment of choice.Methods1．To measurement and analysis the piriform aperture shape of100healthy adultwith CT three-dimensional reconstruction technique,formulate medical referencerange.2．To measurement the cleft lip patients with pyriform aperture area, analysis ofthe relationship between the measurement project, seek malformed critical point，tryto classificate the piriform aperture deformityResults1．The piriform aperture shape change gradually from the "triangle" to "the oval",with the vertical diameter, transverse diameter and basal diameter relationships, themost common type is hexagon with the blunt top, bottom angle and the arc edge.Transverse diameter, vertical diameter and basal diameter reference ranges were:(21.02~30.86) mm,(21.30~41.81) mm,(13.11~35.10) mm.2．The three-dimensional direction change of cleft lip patients ipsilateral piriformaperture are positive correlation.3．The classification of piriform aperture deformity,(X represents the horizontaldirection than the ipsilateral shift; Y represents the vertical direction than theipsilateral shift; Z represents the dorsoventral direction than the lateral shift)Level one, x≤3.1mm, Y≤2.5mm, z≤3.4mm, mild malformation.Level two,3.1mm <x≤5.2mm,2.5mm<y≤5.7mm,3.4mm <Z≤5.3mm,moderate deformity; Level three, x>5.2mm, Y>5.7mm, z>5.3, severe deformity.Conclusions1．The piriform aperture shape of healthy adult present different morphologyaccording to the change of vertical diameter, transverse diameter, basal diameter andthe relationship between the three.2.The nasal basal depression and shift deformity will be more significant whenthe depression and degree of the piriform aperture increase.3．According to the degree of deformity to selecte the operation mode,Level one, mild deformity, only for soft tissue repair can achieve satisfactoryresults.Level two, moderate deformity, using soft tissue repair, medical implants(acellular dermal matrix, expanded etc.) implantation operation mode correctedeformity.Level three, severe deformity, the operation mode of alveolar cleft repair, bulkinsertion, soft tissue repair.