去表皮瘢痕组织瓣重建患侧人中嵴修复单侧唇裂继发畸形

Using deepidermidalized scar tissue flap to reconstruct philtral column and repair secondary deformities of unilateral cleft lip with the improved Millard Ⅱtechnique

目的:采用仿MillardⅡ术式矫正单侧唇裂继发畸形的同时利用上唇去表皮瘢痕组织瓣重建患侧人中嵴。方法:2005年2月～2008年4月,对10例单侧唇裂继发畸形患者应用仿MillardⅡ术式矫正唇鼻畸形,同时利用C瓣携带的上唇去表皮瘢痕组织瓣重建患侧人中嵴。结果:所有患者术后切口愈合良好,C瓣全部存活,未出现瘢痕组织瓣坏死。随访3～12个月,患侧鼻小柱得到明显延长,两侧鼻孔基本对称。再造的人中嵴稍隆起、两侧对称、人中显现。唇弓形态改善,唇峰基本对称,红唇厚薄一致,术区瘢痕不明显。畸形矫治效果较术前明显改善。结论:应用仿MillardⅡ术式矫正单侧唇裂继发畸形的同时利用以C瓣供血的去表皮瘢痕组织瓣重建患侧人中嵴,使得以前需切除遗弃的组织得到充分利用,重建的人中嵴可使整复的上唇外形更为逼真、生动。临床实践证明此方法是安全可行的。

Objective To use the improved Millard Ⅱ technique for correcting secondary deformities of unilateral cleft lip and reconstruct philtral column with the upper lip deepidermidalized scar tissue flap. Methods The improved Millard Ⅱ technique was used to correct secondary deformities of unilateral cleft lip in 10 patients from February of 2005 to April of 2008 and philtral column was reconstructed with the upper lip deepidermidalized scar tissue flap carried by C-flap. Results Postoperative wounds healed very well for all patients. C-flaps all survived completely, no scar tissue flaps necrosis .The postoperative follow-ups with 3-12 months revealed good results of the prolonged columella nasi, symmetrical nostrils and philtrums, good-shaped cupid＇s bow and invisible scar . Deformities were better corrected than before. Conclusion To use the improved Millard II technique for correcting secondary deformities of unilateral cleft lip and reconstruct philtral column with the upper lip deepidermidalized scar tissue flap carried by C-flap, it makes scar tissue which was abandoned before to be fully utilized for correcting deformities and reconstruction of philtral column, the reconstruction of philtral column may achieve more normal and vivid upper lip shape. Clinical practice has proved that this technique is safe and feasible.