双侧唇裂继发鼻畸形的矫正

Secondary rhinoplasty in bilateral cleft

目的通过对双侧唇裂继发鼻畸形进行细致的病理解剖学分析,制定出具体的治疗目标,探讨矫正的有效手术方法。方法以双侧唇裂继发鼻畸形的病理解剖学为基础,将手术程序分为鼻小柱及鼻尖整形、鼻翼软骨的整形、鼻底的整形3个连续的步骤。结果自2000年以来应用上述方法手术矫正36例,其中畸形严重的双侧完全性唇裂术后患者22例,占61.6%。所有病例术后伤口均Ⅰ期愈合,鼻外形明显改善,无感染及皮瓣坏死等并发症发生。术后随访10～24个月,平均17个月,满意率高达100%。结论双侧唇裂继发鼻畸形具有其特有的病理解剖学特征,以解剖学特征基础制定具体手术方案,确保了最终疗效的满意率。

Objective To establish concretely therapetutic goals and to explore an effective surgical method by meticulously analyzing the anatomic features of secondary rhinomalformation in the bilateral cleft. Methods Based on these anatomic and pathological features of secondary rhinomalformation in the bilateral cleft, we devided the operation into three continuous processes: plasty of columella and nose tip, plasty of alar cartilage and plasty of nasal floor, so that the therapeutic goals could be achieved easily. (36 cases) were treated with above technique since 2000, among which there were 22 cases of complete bilateral cleft, accounting for 61.6% of all the cases. Follow-ups were 10 to 24 months(mean 17 months). (Results All )of the 36 patients showed first-stage wound healing and significant improvement in the appearance of their noses. No infection and flap necrosis occurred. Almost all the patients were satisfied with the late effect. Conclusion The secondary rhinomalformation in the bilateral cleft possess unique anatomicopathological features, which determine the choice of surgical methods. The surgeons should make meticulous evaluations and establish concretely surgical procedures so as to achieve the final outcome.