口轮匝肌分层劈开并褥式缝合在单侧唇裂继发畸形人中重建中的应用

Layered splitting and mattress-suturing of orbicularis oris muscle in repairing secondary deformity of philtrum in patients with unilateral cleft lip

目的探讨单侧唇裂术后继发畸形人中重建的方法及疗效。方法采用口轮匝肌分层劈开并褥式缝合法对52例单侧唇裂术后继发畸形患者进行唇畸形修复，术后根据再造人中嵴高度和上唇瘢痕2项形态学指标进行疗效评价。结果术后切口均一期愈合；随访12～24个月，47例形态学评分2～4分，重建人中嵴及人中凹结构自然，局部瘢痕不明显，外形满意；5例形态学评分为5分，重建人中嵴略低于健侧，遗留瘢痕略明显。结论采用口轮匝肌分层劈开并褥式缝合方法重建人中嵴和人中凹解剖结构方法简单，用于治疗单侧唇裂继发唇畸形疗效满意。

Objective To observe the effect of modified surgical technique on reconstructing the philtrum in patients with unilateral cleft lip and secondary deformity of philtrum. Methods Fifty-two patients underwent layered splitting and mattress-suturing of orbicularis oris muscle to repair secondary deformity of philtrum after unilateral cleft lip operation. The aesthetic outcome of the philtrum ridge and the scar were scored before and after the surgery. Results The patients were followed up for 12 to 24 months. Good symmetry of the bilateral philtral ridges was achieved in 47 out of these 52 patients, with the postoperative scores for aesthetic outcome of 2 to 4. Only five patients showed widening of the philtral ridges and less prominent philtral ridges on the reconstructed side than on the normal side. Conclusion The technique of layered splitting and mattress-suturing of orbicularis oris muscle is simple and effective for repairing secondary deformity of philtrum in patients with unilateral cleft lip.