健侧弧线手术切口及三维肌肉重建修复单侧唇裂的临床效果

Repair of unilateral cleft by contralateral arc incision and 3D reconstruntion of lip muscle

目的探讨健侧弧线手术切口及三维肌肉重建修复单侧唇裂的临床效果。方法对20例单侧唇裂患者，运用一种新的单侧唇裂修复术进行修复，应用三维重建上唇肌肉解剖，使黏膜、肌肉及皮肤恢复正常的解剖及应力结构，手术瘢痕设计为直线，位于人中嵴的轮廓线上，重建人中及人中嵴，减少术后瘢痕。结果20例无局部感染、无出血、无复裂者，切口均Ⅰ期愈合。患者唇弓线连续性良好，形态对称，人中及人中嵴形成良好，手术瘢痕位于人中嵴上，比较隐蔽。术后随访1～8个月，未见上唇瘢痕明显挛缩，鼻唇部外观恢复良好。结论这种改良方法定点及切口设计简单，手术后瘢痕少，且在轮廓线上，手术后对称性好，能最大程度恢复患者鼻唇外观，手术效果满意，是一种可行的单侧唇裂修复术的改良方法。

Objective To explore the effect of reconstructing unilateral cleft lip by changing the arc-shaped incision, combined with the 3D reconstruction of upper lip muscles. Methods Twenty unilateral cleft lip patients were treated by using a new surgical operation, the 3D reconstruction of upper lip muscle, to restore normal anatomy and stress of the mucous membrane, muscle and skin. Operation scar was designed for straight line, located on the philtral ridges of the contour line; phitrum and philtral ridges were rebuilt, and postoperative scar reduced. Results A lot of 20 patients had no local infection, hemorrhage, complex crack, and were stage I incision healing. Followed up for 1-8 months postoperatively, the patient＇s lip bow line continuity was good, with symmetrical shape and good phitrum and philtral ridges; scar was hidden on the philtral ridges of the contour line, and no obvious upper lip scar contracture found through the follow-up period. Conclusions This improved method is simple in the incision design, and less scar hidden on the philtral ridges of the contour line after operation, which can maximize the recovery of the appearance of nose and upper lip with satisfactory effect. It is a feasible improvement method of repairing unilateral cleft liD.