多个口轮匝肌黏膜瓣修复口角瘢痕挛缩畸形疗效探讨

Clinical Study of Multiple Orbicularis Oris Muscle Mucosal Flaps in the Treatment of Scar Contracture Deformity in the Corner of the Mouth

目的:探讨应用多个口轮匝肌黏膜瓣修复口角瘢痕挛缩畸形的临床效果。方法:2017年6月-2019年12月,对笔者医院收治的12例烧伤后口角瘢痕挛缩畸形患者,24个口角,采用多个口轮匝肌黏膜瓣修复,一侧口角制备3个口轮匝肌黏膜复合组织瓣,以此特别充分松解口角黏膜面的环形挛缩带,无张力缝合覆盖新口角处。拆线后叮嘱患者坚持佩戴开口器。采用门齿间距测量数据来客观比较术前术后张口程度。结果:12例患者术后即刻效果满意。随访12~30个月,患者均效果满意,无再次挛缩复发。术后门齿间距明显大于术前,差异有统计学意义(P<0.01)。结论:多个口轮匝肌黏膜瓣治疗口角瘢痕挛缩畸形的临床疗效确切,尤其适合重度口角挛缩,手术方法简单易行。

Objective To implore the clinical effect of multiple orbicularis oris muscle mucosal flaps in the treatment of scar contracture deformity in the corner of the mouth.Methods From June 2017 to December 2019,12 patients(24 mouth corners)with scar contracture deformity in the corner of the mouth after burn were treated in our hospital.Multiple orbicularis oris muscle mucosal flaps were used for surgical treatment.Three orbicularis oris muscle mucosal flaps were prepared on one side of the corner of the mouth so as to fully release the circular contracture zone especially on the mucosal surface of the corner of the mouth.Then cover the new corner of mouth with no tension sutures.After removing the suture,the patients were instructed to wear the mouth opener.The data of incisors distance measurement were used to compare the degree of mouth opening before and after operation.Results The 12 patients were satisfied with the immediate shape.The follow-up period was 12-30months.The patients were also still satisfied with the results.There was no recurrence of contracture.The distance between the incisors after operation was significantly larger than that before operation,the difference was statistically significant(P<0.01).Conclusion Multiple orbicularis oris muscle mucosal flaps are effective in the treatment of scar contracture deformity in the corner of the mouth,especially suitable for severe contracture,and this surgical method is simple and easy to perform.