tailieunhanh - Cleft Lip and Palate - part 4

Ở cấp độ này, đường hàng không đã được gần như hoàn toàn occluded. So sánh với ba nhân vật còn lại, các lứa tuổi 0-8-10, 1-1-0 và 3-5-12, cho thấy cấu hình của các cấu trúc trong trường hợp bình thường sau khi đóng cửa của hàm ếch. Đường hàng không trong kích thước posteroanterior của nó là khá rộng | Chapter 8 Pierre Robin Sequence 217 Fig. . Pierre Robin sequence. A series of tracings of the lateral film from 3 months 1 day of age 0-3-1 to 3 years 5 months 12 days 3-5-12 . The pharyngeal airway is filled in black and the stippled area denotes the border of the tracheotomy tube is visible in the first two films. Soon after birth 3 and 4 months of age the dorsum of the tongue is visible at a level above the palatal plane within the palatal cleft space. Posteriorly the tongue just above the epiglottis impinged on the airway. At this level the airway was almost completely occluded. Comparison with the remaining three figures ages 0-8-10 1-1-0 and 3-5-12 reveals the configuration of these structures under normal circumstances after closure of the cleft. The airway in its posteroanterior dimensions is fairly wide and the tongue occupies a more protrusive relationship to the mandible. Reprinted with permission from 1 growth of the cranial vault the maxilla and the middle face and the increase in length and height of the mandible Fig. . Gradual improvement in the facial profile was recorded by the changes in the facial angle and in the angle of convexity. The facial angle is a measure of the degree of protrusion or recession of the chin. In this instance the facial angle increased from 64 at 3 months of age to 70 at the age of 3 1 2 years indicating a reduction by 6 in the recessiveness of the chin. While the mandible is still in a retru-sive relation to the rest of the face the potential for further improvement with continued growth still exists. The changes in the angle of convexity were more interesting. This measurement relates the maxilla to the total facial profile. At 3 months of age the angle of convexity was 140 and at 3 1 2 years it measured at 154 . The integrated growth of the several areas of the face was such as to improve the overall configuration of the facial profile. Serial photographs at 2 months at 13 months and at 3 years of age .