唇裂整复术的现代概念

Modern Concepts of Unilateral Cleft Lip Repair.

目的 :结合单侧唇裂整复术的最新进展对唇裂修复更精细的成形技术进行探讨 ,提出唇裂整复术的现代概念。方法 :现代唇裂修复术的概念主要对人中嵴的再造、鼻堤的成形和红唇的修复提出了更精细的要求 ,对旋转推进原则中C瓣的应用也有了新的认识。本文对 82名单侧唇裂进行了临床应用 ,堤状隆起和星状结节的再造保证了鼻堤的恢复 ;通过内缝合技术恢复鼻唇沟及上唇的立体形态 ;白唇高度的恢复根据具体情况 ,C瓣应用三种方法的不同选择对畸形的矫正更为合理 ;人中嵴采用肌缘错位缝合进行再造 ;红唇的整复强调了干性红唇、湿性红唇及唇吻线的重要性。术后第 3个月 ,以白唇高度、上唇形态、朱缘弓、红唇形态、鼻穹隆、鼻堤、唇部疤痕 7个内容的2 0个项目对唇裂术后效果进行综合评估。结果 :随访例数 74例 ,随访率 90 .0 0 %。 5 8例整复效果理想 ,16例整复效果一般。在 7个内容中 ,除鼻穹隆和鼻堤的整复整复效果相对欠佳外 ,其他内容均可以达到比较满意的效果。结论

Objective:Purpose the aims of this study were to explore the fine plastic techniques of cleft lip repair according to the current research situations and to provide the modern concepts of unilateral cleft lip repair.Methods:The modern concepts of unilateral cleft lip repair were focus on reconstruction of the Cupid's bow, nasal seal and cheiloplasty. It also provided new understanding on the use of C-flap in rotate advancement methods.Several techniques were used in this study on the unilateral cleft lip repair of 82 cases. Reconstruction of barrier prominence and asteroid process in nasal floor plasty can be propitious to nasal seal rehabilitation. Inner-suture technique can be good to nasal-lip groove, lip-facial groove and upper lip 3-D morphology.Proper usage of C-flap will be according to the deformity type.Muscle cross-suture technique was used in Cupid's bow reconstruction.The importance of dry, wet vermilion and kiss line were emphasized in cheiloplasty. 6-0 suture thread use to decrease the scar.The postoperation results will be evaluated according to the 20 measurements of lip and nose after 3 month of operation.Results:74 cases were followed in 82 samples. In 74 cases the outcomes of 58 patients were satisfactory otherwise the common results of 16 cases.Besides the nasal alar and seal reconstruction the measurements were satisfactory.Conclusions:It was of importance that the advancement of cleft lip repair concepts to promote the postoperation effects.