改良直线缝合法功能性修复重度双侧唇裂

Functional treatment for severe bilateral cleft lip with improved straight line closure

目的:探讨应用改良直线缝合法功能性修复重度双侧唇裂的方法和临床效果。方法:在直线缝合法基础上通过设计侧唇的红唇黏膜肌瓣,旋转于前唇下方修复前唇唇红及唇珠;在前唇瓣侧方设计蒂在鼻中隔方向的近三角形皮瓣(C瓣),在鼻前庭底部设计皮瓣(G瓣)同时,在鼻底裂隙两侧设计鼻黏膜瓣(D瓣和H瓣),以封闭鼻底;离断口轮匝肌的异常附着,重建口轮匝肌的连续性。结果:术后患者上唇及唇红丰满,动态畸形不明显,鼻底封闭良好。结论:此法修复重度双侧唇裂可获得较好的上唇形态,减少"口哨"畸形?口鼻瘘及术后动态畸形的发生。

Objective： To explore the operation method and clinical effect of treatment for bilateral cleft lip with improved straight line closure.Methods： On the basis of straight line closure,the vermilion and anterior lip pear were repaired with the muscle-vermilion labial flap of lateral lip.In order to close nasal floor,flap-C from lateral wall of anterior lip and flap-G from nasal wing base were designed,meanwhile,nasal mucosa flap-D and flap-H from two sides of nasal base fissure were designed.The function of the orbicularis oris was repaired by cutting off the anomaly adhesion of the orbicularis oris.Results： The post-operational upper lip was thickened together with good shape and vermilion color,there was no obvious dynamic abnormality,nasal floor was closed well.Conclusion： The improved straight line closure can obtain good shape of lip,reduce the whistling deformities,oronasal fistula and dynamic abnormality.