单侧唇裂术后继发畸形的治疗

Treatment of Secondary Lip and Nasal Deformities of Unilateral Lip Cleft

目的探讨唇裂术后继发唇鼻畸形的修复方法。方法针对35例单侧唇裂术后继发畸形的不同部位及程度采取不同的方法修复,特别在鼻畸形中尝试用记忆合金线缝合固定,均获得较满意效果。结果1例术后3个月再次入院修复,少数患者患侧鼻翼较薄弱,但外形均明显改善。结论唇裂术后继发唇鼻畸形的修复没有固定的术式。Ⅱ期修复往往比Ⅰ期手术更为复杂且患者要求较高,宜采取简单、创伤小、效果满意的术式。鼻畸形严重患者需将软骨彻底分离,甚至可考虑自体软骨或人造材料充填。

Objective To explore methods for repairing secondary lip and nasal deformities of unilateral lip cleft.Methods 35 cases with secondary lip and nasal deformities of unilateral cleft lip were treated with different procedures according to the different locations and degree of secondary deformities.Furthermore,memorial alloy suture was applied in secondary nasal deformities with satisfactory results.Results One patient received another revision surgery three months after operation.A few patient had weak alae. Dramatic aesthetic improvement were achieved in all patients.Conclusion The method for repairing secondary deformities of unilateral cleft lip is not a fixative procedure which is more complicated than the cleft repair surgery.The patients often have a high expectation.We advise a simple,less traumatic,and effective procedure.The alar cartilage needs to be freed completely from the overlying skin in the severe nasal deformities,cartilage autograft or artificial materials transplantation are often necessary to correct the deformities.