单侧唇裂及鼻畸形早期同时修复的临床观察

Evaluation of outcomes of simultaneous rhinoplasty for early unilateral cleft lip repair

目的:探讨先天性单侧唇裂修复术时,同期行鼻畸形矫正的临床效果,最大限度地减少唇裂术后遗留鼻畸形。方法:67例患者,年龄3月到四岁半,用iM l l ardⅠ或Ⅱ或改良Ⅱ式等手术方法基础上同时利用唇裂手术切口入路行鼻小柱、鼻翼基部肌束松解,大翼软骨松解、复位、固定,术后配合佩戴唇裂专用硅胶鼻模6月～1年维持鼻形态。结果:随访6个月～5年,效果良好者为53例,占79.1%。结论:在单侧唇裂整复的同期行鼻畸形的矫正,不增加新的切口,却能取得较满意的临床效果;且早期鼻畸形的消除和减轻,对于患儿长期的心理健康发育是非常有益的。

Objective The clinic outcomes were discussed for rehinoplasty simultaneous with cheiloplasty at early stage to reduce nasal deformity.Methods Sixty-seven patients（rang from 3 months to four and half years old）with cleft lip treated by rehinolasty at the same time as the first cleft lip repair.Treatment applied MillardⅠorⅡor improved technique involving columella nasi and alar base muscle and cartilage relief and relocation,nose model is applied to maintain nasal shape for half to one year.Results Fifty-three patients were gotten satisfaction for postoperative appearance at the 6 month to 5 years follow-up visit,it is 79.1% account for the whole patients.Discussion Rehinoplasty incorporated with cheiloplasty is an effective way to reduce and delete the nasal deformity at the early first surgical procedure.It＇s helpful for children to develop a healthy psychology.