双侧“V”形唇红瓣联合口轮匝肌成形术修复双侧唇裂术后凹陷畸形

Combined Double "V" Flap and Reconstruction of Orbicularis Oris Muscle for The Treatment of Secondary Bilateral Cleft Lip Deformity

目的探讨双侧唇裂修复术后继发红唇凹陷畸形的有效矫治方法。方法本组患者26例,均为双侧唇裂一期手术后。术中,首先切除原有瘢痕,解剖分离出两侧口轮匝肌,重建连续的口轮匝肌肌环;然后在双侧红唇瓣上分别设计"Y"型切口,三角瓣尖端朝向中线;最后将双侧"V"型三角黏膜瓣向中线推进交叉缝合,重建唇珠。结果 26例患者红唇口哨畸形均得以矫正,上唇人中得以延长。所有患者术后随访3个月至2.5年,效果良好。结论在口轮匝肌重建基础上,应用"V"型皮瓣推进交叉成形术,是种操作简单、效果良好的修复双侧唇裂术后继发红唇凹陷畸形的方法 。

Objective To explore an effective method of the treatment for the secondary bilateral cleft lip deformity. Methods Combined double ＂V＂ lip flaps with muscle repaired technique for the correction of secondary bilateral cleft lip deformity. Twenty six patients with secondary bilateral cleft lip deformity were treated. The original scar was removed and orbicularis oris muscle on both sides was dissected. Continous ring of orbicularis oris muscle was reconstructed ＂Y＂ incision was designed on the red lip flap of both sides. The top of triangle flap pointed middle line. ＂V＂ triangle flaps were advanded to middle line and sutured crossly. Results The deformity of red lip was corrected and the philtrum of upper lip was lengthened. All the 26 patients were followed up 3 months to 2.5 years. Conclusion Combined double ＂V＂ flap and reconstruction of orbicularis oris muscle is an effective method to treat secondary bilateral cleft lip deformity.