口唇口蓋裂患児の口腔保健関連QOLに対する親の認識に術前の鼻槽骨成形が与える影響について

Impact of Presurgical Nasoalveolar Molding on the Parental Perceptions of Oral Health-related Quality of Life of Children with Cleft Lip and Palate.

抄録

AIM:

本研究の目的は、術前鼻槽骨成形（PNAM）を行った口唇口蓋裂患児の口腔保健関連QOL（OHRQoL）を調査し、その結果を年齢・性別をマッチさせた口唇口蓋裂のない対照群と比較することである。

AIM: The study aimed to examine the oral health-related quality of life (OHRQoL) of children with cleft lip and palate who were treated with presurgical nasoalveolar molding (PNAM) and to compare the results to age- and gender-matched controls without cleft lip and palate.

材料と方法:

PNAMで治療を受けた口唇口蓋裂の子ども51名の両親に、有効なアラビア語版の子どもの口腔衛生影響度プロファイル（COHIP-SF）を実施し、PNAMの使用経験について評価してもらった。口唇口蓋裂の治療を受けた子どもたち（研究グループ）は、口唇口蓋裂のない子どもたち（対照グループ）と年齢と性別を一致させた。COHIP-SFドメインの違いをMann-Whitney検定を用いてグループ間で比較した。

MATERIALS AND METHODS: Parents of 51 children with cleft lip and palate who were treated with PNAM were administered a validated Arabic version of the short-form child oral health impact profile (COHIP-SF) and were asked to rate their experience with PNAM. The children with treated cleft lip and palate (study group) were age- and gender-matched to children with no cleft lip and palate (control group). The differences in COHIP-SF domains were compared between groups using the Mann-Whitney test.

結果:

テスト群の子どもたちは、COHIP-SFのスコアが有意に高かった( < 0.001)。しかし，口腔衛生（＝0.532）と口腔機能（0.232）の領域では，有意な差はなかった。しかし，社会性と情動の領域では有意な差が見られた（< 0.001）。口唇裂・口蓋裂の子どもを持つ親のほとんど（86％）が、PNAMを他の親に勧めたいと感じていた。

RESULTS: The children in the test group had significantly higher COHIP-SF scores than in the test group ( < 0.001). However, there were no significant differences in the oral health ( = 0.532) or the oral function (0.232) domains. There were, however, significant differences in the socioemotional domain ( < 0.001). Most of the parents (86%) of children with cleft lip or palate felt that they would recommend PNAM to other parents.

結論:

OHRQoLの口腔衛生領域と機能領域には差がなかったが，PNAMで治療を受けた口唇口蓋裂患児は，年齢と性別をマッチさせた対照群と比較して，OHRQoLの社会情緒領域のスコアが有意に低かった．

CONCLUSION: While there are no differences in the oral health and functional domains of OHRQoL, children with cleft lip and palate treated with PNAM have significantly lower scores in the socioemotional domain of OHRQoL when compared to age- and gender-matched controls.

臨床的意義:

術前の鼻槽骨形成は，口唇口蓋裂患児の OHRQoL に悪影響を及ぼさない．

CLINICAL SIGNIFICANCE: Presurgical nasoalveolar molding does not have any negative impact on the OHRQoL of children with cleft lip and palate.