摘要
目的探讨双侧唇裂与鼻畸形同期整复的方法和美容效果。方法2003年3月~2004年12月,收治先天性唇裂患儿26例,男14例,女12例。年龄10个月~11岁。其中双侧完全性唇裂13例,均伴双侧完全性腭裂;双侧不完全性唇裂9例,均无腭裂;混合性唇裂4例,均伴单侧完全性腭裂。应用原长法的原则进行唇裂整复,术中解剖口轮匝肌,复位后进行框式缝合;唇珠的形态由侧唇红唇肌肉瓣完成;红唇缘原有自然形态完整保存;同期初步矫正鼻畸形。结果术后患儿创面均期愈合。鼻底宽度及丰满度均较满意,唇弓形态好,无口哨畸形。上唇静态及动态时外形均较好。26例均获随访10d^3个月,双侧不完全性唇裂患儿有较好的鼻尖及鼻孔形态,均不需进行二期手术;双侧完全性唇裂患儿有一定的鼻尖及鼻孔形态,仅遗留鼻小柱过短;混合性唇裂患儿两侧鼻翼基脚稍不对称。结论双侧唇裂与鼻畸形同期整复时,对传统的整复方法进行优化组合,取长补短,并进行适当完善和修改,另加一定的缝合技巧,可在术后近期静态与动态均达到较满意的效果。
Objective To detect the operative technique and aesthetic problem of reconstruction to deformity of bilateral cleft lip. Methods From March 2003 to December 2004, 26 patients with bilateral cleft lip were treated, aged 10 months to 11 years. Of 26 patients, there were 13 bilateral complete cleft lip and palate, 9 bilateral incomplete cleft lip and 4 mixed cleft lip with unilateral complete cleft palate. The chief design principle was keeping the length of prolabium. During operation, sufficient dissociation was made in the base of the ala base and orbicularis oris muscle to reconstruct these structures. The circle suture was made for the bilateral orbicularis oris muscle. The shape of vermilion was achieved by lateral red lip muscle flap and simultaneous simple rhinoplasty was performed. Results Primary healing of the incisions was achieved in all cases. After the 10 days-3 months follow-up, the results were satisfactory in the width and chubbiness of the nose bottom, the shapes of nostril and Cupid＇s bow were good without whistle deformity. The apperance of upper lip was good in either dynamic or static state. Conclusion Excellent shapes and function of the nose and lip, and opportunity for two stage repair could be obtained with this method, which being believed important methods for the primary repair of bilateral cleft lip.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2006年第9期899-901,共3页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
双侧唇裂
鼻畸形
整复术
Bilateral cleft lip Nose deformity Repair approach
