应用改良下三角瓣法修复单侧唇裂术后继发畸形临床研究

Modification of Inferior Triangle Technique for Cleft Lip Secondary Revision

目的单侧唇裂术后继发畸形常表现为可见的瘢痕,不对称的解剖外观,唇红缘不齐等。因此设计一套完整的修复多个缺陷,重建解剖标志的方法是必要的。本研究通过人体测量方法来评估采用改良下三角瓣法修复唇裂术后继发畸形的结果。方法回顾性分析使用改良下三角瓣法修复唇裂术后继发畸形的患者的临床疗效。采集标准的术前和术后照片,并测量各解剖点。结果由两个独立的,双盲的人员评估比较,采用配对t检验。结果本研究纳入对象共18例(患者平均年龄9.27岁,女性,n=8),随访时间最长24个月。术前PCH、HL、HL'差异有统计学意义(P<0.05)。术后PCH、HL、HL'差异无统计学意义(P>0.05)。手术侧的△PCH、△HL和△HL'与健侧的△PCH、△HL和△HL'之间有显著变化(P<0.05)。术后人中高度有显著变化(P<0.05)。PCW及MW有显著变化(P<0.05)。结论使用改良下三角瓣法修复唇裂术后继发畸形,解剖测量有明显变化,可显著改善唇部外观。

Objective Unilateral cleft lip revision may address visible scars, unequal anatomical boundaries or vermillion inequi- ties, et al. A complete recreation of the defect is necessary. This study antbropometrically evaluates the results of cleft lip revision following modified inferior triangle. Methods A retrospective analysis of patients who underwent cleft lip revision using the modified inferior triangle was included. Standard pre -and postoperative photographs were obtained and evaluated. Results were corroborated by two inde- pendent, blinded reviewers, and compared using the paired t test. Results Totally 18 patients were included （mean age, 9.27 years; female, n = 8） , over a 24 month period. Significant differences （ P 〈 0.05 ） were seen in the PCH, HL, HL＇ preoperatively. No signifi- cant differences （P 〉 0.05 ） were noted in the PCH, HL, HL＇ postoperatively. Significant changes （ P 〈 0.05 ） between A PCH, A HL and A HL＇ of cleft side and A PCH, A HL and A HL＇ of noncleft side were found. Philtral height showed significant changes （P 〈 0.05 ） after modified inferior triangle. Significant changes （P 〈 0.05） were found in the PCW and MW. Conclusion Cleft lip revision is effectively performed by the modified inferior triangle flap, improving the lip appearance with improved antropometric measures.