改良式Millard法修复单侧唇裂的临床应用

Clinical application of modified Millard＇s technique on repair of unilateral cleft lip

目的 探讨应用改良式Millard法修复单侧唇裂的效果.方法 对42例单侧唇裂患儿应用改良式Millard法,将健侧鼻小柱点移至患侧鼻小柱根部,充分分离错位的患侧口轮匝肌,将C瓣下的小肌束与患侧鼻束对合,部分重叠.结果 本组42例患儿,有3例因术后鼻腔分泌物多出现轻度感染,其余患儿均Ⅰ期愈合.术后随访1～36个月,平均6个月,效果满意.结论 改良的Millard法唇裂修补术可以恢复患儿患侧唇高、唇长,术后无肌隆起,效果满意.但Ⅰ期术后患儿的患侧外鼻形态须行Ⅱ期修复术才能获得满意效果.

Objective To explore the clinical effects of modified Millard＇s method on repair of unilateral cleft lip. Methods Modified Millard＇s method was adopted for repairing unilateral cleft lip in 42 patients. The nasal columella of the uninjured side was transferred to the bottom of the nasal columella of the injured side, the allotropic orbicularis oris muscle was dissected snfficiently, and the small muscle bundle under the ＂C＂ skin flap was connected with the muscle bundle at the bottom of the ala nais partly overlapped. Results Forty-two patients healed primarily except for 3 cases with mild infection because of the postoperative secretions from the nasal cavity. After 1 - 36 months following up, all cases received satisfactory results. Conclusion Generally, the modified Millard＇s technique on repair of unilateral cleft lip can recover the hohe der schleimhautlippen and thelength of the lip. Secondary repair is still needed for the patients to obtain the cosmetic outline of external nose.