伴隐性唇裂双侧不对称性唇裂的手术修复效果初探

Surgical repair of the asymmetrical bilateral cleft lip accompanied by the recessive cleft lip

目的探讨伴有隐性唇裂的双侧不对称性唇裂的手术修复方式。方法自2007年9月至2011年9月,我中心共完成了125例双侧唇裂修复,从中筛选出18例双侧不对称性唇裂,其中有6例伴有隐性唇裂。6例中有3例行一次性手术,即将两侧裂隙分别按照单侧唇裂来修复,先修复裂隙较大的,再修复隐性唇裂。有2例则按照双侧完全性唇裂的方法来修复。有1例则只修复裂隙较大一侧,隐性唇裂未予以修复。结果 3例按照单侧唇裂分侧修复者,在术后1个月及3个月的随访中,红唇及人中嵴的外观均得到满意的效果,2例按照双侧完全性唇裂修复者,上唇组织较紧,白唇瘢痕明显,组织量缺失较多。1例只修复裂隙较大的一侧,隐性唇裂仍存在畸形,需二期手术修复。结论伴有隐性唇裂的双侧不对称性唇裂,采用单侧唇裂分侧修复一期完成,可达到较好的效果。

Objective To explore the surgical repair techniques of the asymmetrical bilateral cleft lip accompanied by recessive cleft lip. Methods Our center had performed 125 cases of the bilateral cleft lip repair from Sep 2007 to Sep 2011. Eighteen cases found with asymmetrical bilateral cleft lip were chosen, of which 6 were accompanied by recessive cleft lip. Among the 6 cases, 3 cases were repaired in only one operation, using the technique of unilateral cleft lip repair to fix both sides of the clefts respectively. First the greater side was repaired and then the contralateral side with the recessive cleft lip was repaired. Two cases were repaired by using the technique of bilateral complete cleft lip repair, and one case was repaired only on the greater side and left the recessive side undone. Results The 3 cases achieved satisfactory results by showing good postoperative appearances of the vermillion and philtrum after one to three months’ follow-up. The 2 cases showed a tight upper lip with an obvious scar formation on the labial region and a great loss of tissue amount. The one case still had deformity on the recessive side and needed a secondary operation. Conclusion Better results could be achieved by using the technique of unilateral cleft lip repair to fix the asymmetrical cleft lip accompanied by the recessive cleft lip.