单侧唇裂术后继发鼻畸形的解剖学综合整复

ANATOMIC CORRECTION ON SECONDARY NASAL DEFORMITY IN UNILATERAL CLEFT LIP TREATMENT

目的:矫正单侧唇裂继发鼻畸形。方法:基于对单侧唇裂鼻畸形的病理解剖学研究和对畸形特征的认识,采用延长鼻小柱、纠正鼻小柱和鼻中隔的偏斜,解剖显露双侧鼻翼软骨、游离塌陷的鼻翼软骨并悬吊固定在对称位置;同时采用自体耳甲软骨和中隔软骨移植,行鼻翼软骨支架重建。通过前庭粘膜瓣的旋转V-Y推进、纠正鼻前庭皱襞、完成鼻畸形的矫正。结果:自1998年至今,应用此法行76例唇裂鼻畸形矫正,其中63例病例经3-12个月随访、效果满意。结论:本手术方法切口暴露好,可直视下操作,鼻畸形整复效果满意。

Objective:To correct the secondary nasal deformity of unilateral cleft lip.Methods:On the basis of patho -anatomical stu dy and the comprehension on the cleft lip nose,our operation procedure includes correction and replacement of t he septum to the middle position,motilization and suspension of the displaced alar cartialges,increas the length of columella on t he cleft side.Results:76patients were treated with this method since 1998.Postoprative follow -up for 3~12months showed that the results are s atisfactory.Conclusion:The clinical applications showed th at there were several advantages for this method,and good results can be g ained by repositioning the total nasal deformity.