成人单侧唇裂继发鼻畸形的整复

Correction of nasal deformity in unilateral cleft lip of adult cases

目的 为单侧唇裂术后常见的继发鼻畸形改善外形 ,解除其心理负担。方法 纠正鼻小柱和鼻中隔的偏斜 ,游离塌陷的鼻翼软骨并悬吊固定在对称位置 ,用Millard术式C瓣、鼻槛组织瓣或上唇瘢痕组织瓣延长患侧鼻小柱 ,必要时用假体或自体组织抬高鼻背、鼻尖和丰满鼻底。1999～ 2 0 0 0年 ,共修复成人单侧唇裂继发鼻畸形 5 0例。结果 所治疗 5 0例术后随访 1～ 12个月效果均较满意。结论 纠正鼻小柱、鼻中隔歪斜 ,延长患侧鼻小柱软组织极为重要。广泛游离患侧鼻翼软骨并复位到正常位置固定 ,才能获得一个对称的鼻尖。如视需要 ,作鼻背鼻尖部和鼻底的充填 ,则效果更佳。

Objective Nasal deformities are very common in unilateral cleft lip cases. They are morphology of alar collapse, nasal floor depression and deviation of the septum. Methods Our operation procedure includes correction and replacement of the septum to the middle position, mobilization and suspension of the displaced alar cartilage and use of a “C” flap, nasal sill flap or a flap of the lip scar tissue to increase the length of columella on the cleft side. An implant or autograft of suitable size is placed, if necessary, in the nasal bridge or/and the nasal floor. Results Postoperative follow up for 1～12 months showed that the results are satisfactory. Conclusions Correction of septum deformity, and increase of the length of the columella on the cleft side are important. An extensive mobilization and reposition of the alar cartilage must be done for obtaining a symmetric nasal projection. If necessary, a fine implant or self-tissue is placed in the nasal bridge and nasal floor, which would make the result much better.;