单侧唇裂术后鼻唇畸形整形方法的改进

The improvement of the methods for the repair of secondary deformity associated with unilateral cleft lip

目的 探讨单侧唇裂术后鼻唇畸形部分手术方法的改进。方法 基于对唇裂术后鼻唇畸形病理解剖的认识 ,在常规手术的基础上 ,鼻底行“Y -V”推进、瘢痕瓣转移 ,以抬高患侧鼻底 ;采用患侧口轮匝肌与鼻小柱、鼻底、鼻翼组织垫及对侧口轮匝肌多层次多部位重叠缝合 ,使上唇饱满 ,更具立体感 ,且防止鼻翼外脚外移复发。结果 自 2 0 0 1年 1月以来 ,经过 4 7例的临床实践 ,术后鼻底丰满 ,上唇人中嵴、人中凹显现 ,随访 3～ 6个月 ,鼻翼外脚外移复发 1例 ,其余效果满意。结论 通过对某些术式进行改进 ,提高了手术疗效 ,减少了畸形的复发。

Objective To improve some methods for the correction of the second deformity associated with unilateral cleft lip. Methods On the basis of patho-anatomical study and comprehension on the secondary deformity associated with unilateral cleft lip, some methods were improved. During operation, Y-V advancement and scar flap transfer were used in order to correct the nasal deformity. The repositioning and suture of orbicular muscle were carried out to correct the deformity of upper lip. Results Since 2001, a total of 47 cases were treated by the procedure above and the satisfactory results were obtained. Conclusion The clinical applications prove that there are several advantages for this methods.