单侧完全性唇裂一期修复中前鼻底重建技术改进

Improved reconstruction of pre-nasal floor during primary cleft lip repair of unilateral complete cleft lip

目的:探索通过改进单侧完全性唇裂一期修复手术的前鼻底重建技术来减少前部口鼻腔瘘发生率的方法。方法:2008年10月至2015年6月在我院接受治疗的单侧完全性唇裂患者102例,前鼻底重建技术未改进组49例,改进组53例,技术改进在于利用Cm瓣和L瓣双层关闭前鼻底直达切牙孔部位,在随访期间观察患侧前鼻底凹陷以及前部口鼻腔瘘的发生率。结果:未改进组的前鼻底和前部口鼻腔瘘发生率为30.6%和91.8%,改进组分别为9.4%和26.4%,统计学检测证实均有显著性差异(P<0.01)。结论:利用Cm瓣和L瓣严密关闭前鼻底可以有效地减少前鼻底凹陷以及前部口鼻腔瘘的发生。

Objective To investigate the way to decrease the rate of pre-palatal ONFs and pre-nasal floor notches by improved pre-nasal floor reconstruction surgery.Methods 102 infants/patients with unilateral complete cleft lip received treatment in PUMCH from October.2008 to June.2015.They underwent primary cleft lip repair（49 treated with and 53 treated without improved nasal floor reconstruction）.Pre-nasal floor was completely reconstructed using Cm flap and L flap in improved surgery.Incidence rate of pre-nasal notches and pre-palatal ONFs were calculated after surgery.Results Incidence rate of prenasal notches and pre-palatal ONFs in improved group（9.4% and 26.4%） were lower than that in unimproved group（30.6% and 91.8%）（P〈0.01）.Conclusion Incidence rate of pre-nasal notches and pre-palatal ONFs can be decreased effectively by improved pre-nasal floor reconstruction using Cm flap and L flap.