Millard法加肌解剖复位术修复单侧唇裂的效果分析

Quantitative analysis of the aesthetic effect for unilateral cleft lip repair using Millard's method with muscular dissection and reposition

目的:探讨采用Millard法加肌解剖术式修复单侧唇裂的手术效果。方法:收集单侧唇裂47例(Ⅱ度唇裂27例,Ⅲ度唇裂20例),精确测量患者手术前后健患侧唇高、唇长及鼻孔宽等数据,对测得数据以SPSS10.0统计软件包进行独立样本的t检验,确定有无显著性差别。结果:无论是Ⅱ度还是Ⅲ度唇裂,健侧唇高、唇长及鼻孔宽手术前后差异无统计学意义(P>0.05),患侧唇高及鼻孔宽手术前后差异有统计学意义(P<0.05或P<0.01)。Ⅲ度唇裂手术前后患侧唇长差异有统计学意义(P<0.05),Ⅱ度唇裂手术前后差异无统计学意义(P>0.05)。Ⅱ、Ⅲ度唇裂唇高、唇长及鼻孔宽术后健患侧差异无统计学意义(P>0.05),Ⅱ、Ⅲ度唇裂术后唇高、唇长健患侧平均差值为正值,术后鼻孔宽健患侧平均差值为负值。结论:应用本术式修复Ⅱ度和Ⅲ度单侧唇裂,可基本恢复唇高、唇长及鼻孔宽,健患侧平均差值可达到统计学上无显著性意义的程度;但唇高和唇长仍矫正不足,对鼻孔宽有矫枉过正作用。

PURPOSE： To evaluate the aesthetic effect of unilateral cleft lip repair using Millard＇s method by quantitative analyses of the anthropometric markings. METHODS： Forty-seven patients with unilateral cleft lip （class Ⅱ： 27 cases, class Ⅲ：20 cases） were investigated in this study. The related anatomical marks of lip height, lip length and width of the nostril were measured before and after cheiloplasty respectively. Student＇s t test was used for statistical analysis with SPSS 10.0 software package. RESULTS： There was no significant difference in the upper lip height and lip length and width of the nostril at the normal side of class Ⅱ and Ⅲ cleft lip before and after cheiloplasty （P〉0.05）. There was significant difference in the upper lip height and width of the nostril at the operated side of class II and III cleft lip before and after cheiloplasty （P〈0.05 or P〈0.01 ）.There was significant difference in the upper lip length of the operated side of class III cleft lip before and after cheiloplasty （P〈0.05）. There was no significant difference between the normal side and the operated side of the upper lip length of class Ⅱ and Ⅲ cleft lip after eheiloplasty （P〉0.05.）. There was no significant difference in the upper lip height and lip length and width of the nostril of the operated side of class Ⅱ and Ⅲ cleft lip after cheiloplasty （P〉0.05）. But the lip height difference, lip length difference between the normal side and operated side were positive, indicating that after operation, the lip height and lip length of the operated side were still shorter than the normal side, though there was no statistic significance. On the other hand, after operation, the average difference of the width of the nostril between the operated side and the normal side was negative, indicating an overcorrection. CONCLUSIONS： Millard＇s technique is useful for repairing unilateral cleft lip, except for a little shortage of the lip height and lip length of the operated side.