改良Millard法功能性修复单侧唇裂16例

Unilateral cleft lip using Millard method:report of 16 cases

目的:观察改良Millard法修复单侧唇裂的效果。方法:基于对Millard、Onizuka及罗慧夫术前设计的理解,在白唇、柱状线及红唇的设计上选择性地综合采用三种设计方法,同时采用患侧口轮匝肌与鼻棘、鼻底及对侧口轮匝肌多层次、多部位重叠缝合。在功能性修复唇裂的同时,使人中嵴显现,且防止鼻翼外脚外移复发。术中使C瓣自然退缩于鼻底,以增加患侧鼻小柱和鼻底的皮肤。结果:16例术后双侧唇高相等,红唇缘延续光滑,唇弓形态自然;人中嵴形态存在,无干燥红唇与湿润红唇交错,无唇外翻;上唇运动时无不正常凹陷和扭曲;双侧鼻孔、鼻翼基底基本对称,形成鼻孔槛,效果满意。结论:改良Millard法是功能性修复单侧唇裂的一种较好的方法。

Objective：To improve the effects of contour and the function of cleft lip using improve Millard method. Methods： The operation of the upper lip,prismatical line and vermilion lip were designed accordiing to the method of Millard, Onizuka and Noordhoff, and oris orbicularis of contralateral side and nasal spine and base of diseased side were sutured by multi-level and place overlap. The founction of cleft lip were recovered, philtrum ridge was emerged and the recurrence of nasal feet offshoring was prevented. C flap shrink back to the bottom of nose to expand the skin of nasal columellar and bottom. Results ： The equal height of bilateral lip, smooth margin of vermilion lip, natural lips bow and philtrum ridge were found without dry, staggering and ectropion vermilion lip. The upper lip movement without normal sag and distortion, the symmetry base of nasal alar to form nostrils were confirmed. The effects were good. Conclusions ： The imprved Millard method is a valuable way, which can recover the founction of unilateral cleft lip.