双侧唇裂修复术中前唇宽度设计对术后面部外形的影响

Progressive Changes of Prolabial Width in Bilateral Cleft Lip after Primary Cheiloplasty

目的:评估双侧唇裂患儿术中设计的前唇宽度以及鼻部生长在术后2年间的变化。方法:选择86例3～18个月双侧唇裂患儿,术中设计前唇上部宽3mm;前唇下部宽4mm的手术切口,术后进行2年的宽度改变临床观察测量,并在术中术后测量鼻底宽度;上唇高度;鼻翼唇峰距,将各组不同时间段测量数据进行整理分析。结果:所有双侧唇裂患儿术后6、12、24个月时前唇宽度进行性增加,按上3mm,下4mm设计前唇手术切口,术后外形较接近正常的人中形态。同时,鼻底宽度;上唇高度及鼻翼唇峰距均有所改变。结论:在行双侧唇裂修复术时,在不影响血供的情况下,前唇宽度设计应足够狭窄,同时前唇长度设计不可过长并尽量维持术前鼻唇角的角度,以期达到术后良好的外形效果。

Objective： To assess the progressive changes of prolabial width and nasal growth in two years after pri- mary cheiloplasty in bilateral cleft lip infants. Methods： 86 cases with bilateral cleft lip at 3 to 18 months of age were repaired by design for upper side 3ram and bottom side 4ram of prolabial width. The progressive changes of prolabi- al width were measured at 6 months, 12 months and 24 months after operation. Meanwhile, the nasal width, the lip height and the distance from alar base to Cupid＇s bow peak were also measured. Results： The results revealed that the prolabial width was significantly lengthened after primary cheiloplasty simultaneously with primary nasal recon- struction in all cases. At the same time, the nasal width and the distance from alar base to Cupid＇s how peak in- creased in length slightly postoperatively, whereas the lip height grew significantly in height year by year. Conclu- sion： The findings suggested that in primary cheiloplasty, the prolabial width should be designed as narrow as possi- ble under an adequate blood supply. Meanwhile, the design of lip height should be balanced and the preoperative na- solabial angle should be maintained.