第一、二鳃弓畸形——面横裂的矫正术改进

Improved technique for macrocheilia

目的 对第一、二鳃弓畸形———面横裂传统的Z成形术缩小口裂方法进行改进 ,以减少口角裂开、动态畸形、瘢痕明显等并发症。方法 ①在上红唇新口角处外侧设计三角皮瓣插入下红唇新口角处内侧。②口轮匝肌解剖复位。③口外皮肤Z形修复的三角皮瓣改由下唇向上唇插入为由上唇向下唇插入。结果 1995年 8月以来 ,为 12例病人进行此手术 ,效果较好。结论 改进后的手术方法设计合理 ,并发症少 ,动态效果较好 ,瘢痕较不明显。

Objective\ To introduce an improved technique for Macrocheilia. The traditional technique for macrocheilia with direct suture and Z-plasty was improved to decrease postoperative complications, e.g. dynamic abnormality, obvious scar and recurrence due to scar contraction. Methods\ Outside of the new commissure, a triangle flap of the upper lip vermilion was designed, created and inserted to the lower lip. The orbicularis oris muscle was anatomically replaced. Skin Z-plasty was made with triangle flap transferring from the upper to the lower instead. Results\ Since August 1985, the new technique has been used in 12 cases of Macrocheilia. All the patients obtained satisfactory results with nice configuration and good function without dynamic abnormality and obvious scar. Conclusion\ The new technique is a more reasonable method for macrocheilia with nice configuration, good function and fewer complications.\;