Læknablaðið - 15.11.1990, Page 62

482
LÆKNABLAÐIÐ 1990; 76: 482
NÝR DOKTOR í LÆKNISFRÆÐI-
ÓLAFURPÉTURJAKOBSSON
Þann 9. mars síðastliðinn lauk Ólafur
Pétur Jakobsson læknir doktorsritgerð frá
Háskólanum í Uppsala. Ritgerðin nefnist
á frummálinu »Repair of isolated cleft
palate. A comparison of one- and two-
stage surgery by dental arch measurements,
cephalometry, and speech analysis«. Hér á
eftir fer útdráttur úr ritgerðinni:
Two different methods for repair of isolated
cleft palate have been used at Akademiska
sjukhuset. Until 1977 the patients were
operated in one stage, while a two-stage
protocol was introduced in early 1977.
Through registration of the dental arches,
cephalograms, and speech recordings, it is
now possible to compare the two methods.
Computer programs were developed for
geometric measurements of X-ray films
and for measurements of dental casts with
digital calipers. The results were incorporated
into a database that also contained all
pertinent clinical data. The registrations were
obtained through a standardized follow-up
system. Statistical evaluation was done with
multivariate linear and logistic regression
analysis and concentrated on the results at 8
years. The four independent variables through
all studies were the surgical method, cleft size,
sex, and age.
Alveolar and dental arch measurements:
There is a statistically significant relationship
between many maxillary alveolar-dental
dimensions and the cleft morphology at
birth. The relation is consistently in the same
direction for all the dependent variables, i.e.,
the larger the cleft at birth, the smaller the
alveolar-dental dimensions. The choice of
surgical method has a statistically significant
Key words: Cleft palate, cleft palate surgery, one-stage
palate repair, two-stage palate repair, cephalometry, dental
cast analysis, speech analysis.
effect on only one variable (dental arch width
at 55 65), while the effect on the remaining
variables is inconsistent.
Cephalometry: There is a statistically
significant relationship between several
measurements and the cleft morphology at
birth. The choice of surgical method has very
little effect on most of the measured variables.
Speech analysis: There is a statistically
significant relationship between the
indipendent variables, i.e., surgical method
and cleft extent at birth, and several dependent
variables. The odds ratio points consistently
in the same direction through most groups,
leading to the conclusions that the one-stage
surgical treatment gives better speech and the
larger the cleft at birth, the worse the speech.