自体软骨移植和改良Abbe瓣矫正双侧唇裂鼻唇畸形

Correction of Naslablia Deformity of Bilateral Cleft Lip by Autogenous Cartilage Grafting and Modified “Abbe flap”

目的 利用鼻底双三角瓣 ,自体软骨移植和改良Abbe’瓣 ,Ⅱ期矫正双侧唇裂术后鼻唇畸形。方法 利用唇裂修复时贮存鼻底两个三角瓣 ,延长鼻小柱 ,并将双侧鼻翼软骨完全游离同时切取耳甲软骨 ,修整后将其移植固定鼻小柱处 ,在下唇唇红中央设计包括下唇全层和小块三角形皮肤的改良Abbe’瓣。结果 本组共施术 2 0例 ,均获Ⅰ期愈合 ,经 0 5～ 5年临床观察及随访 ,术后效果满意 ,未见鼻唇及切取软骨耳廓发育受影响。结论 利用唇裂修复时贮存鼻底的双三角瓣 ,自体耳甲软骨移植和改良Abbe’瓣行双侧唇裂Ⅱ期矫正鼻小柱过短 ,鼻尖鼻翼低平 ,上唇过紧 ,唇珠和唇弓外形差效果肯定。

Objective To correct nasolablia deformity after operation of bilateral cleft lip by nasifundus bilateral triangular flaps, autogenous cartilage grafting and modified “Abbe flap” at second stage Method Nasicolumella was prolonged with two triangular flaps stockpiled at nasal fundus during repair of cleft lip Bilateral alar cartilages were completely dissected Autogenous conchal cartilage was harvested, shaped, inserted into the nasicolumella and fixed in position Modified “Abbe flap” including entire stratums of inferior lip and small triangular skin was designed at middle inferior lip vermilion Result All cases of this group (25 cases) healed by first intention After clinical observation and following visition through 0.5—5 years, operative effect was satisfied, without interference to growth of lip and nose and auricule Conclusion It was positively effective to correct postoperative deformity such as short columella, low nasal tip and alae, tight upper lip, poorly shaped labial bow and lip pearl at second stage by nasifundus bilateral triangular flaps stockpiled during repair of cleft lip, autogenous cartilage grafting and modified “Abbe flap” Indication and problem concerned during or after operation was discussed