双侧唇裂或唇腭裂患者唇裂术后鼻唇畸形的Ⅱ期整复治疗

Secondary Management of the Nasal and Labial Deformities in the Patients with the Bilateral Cleft Lip or Bilateral Cleft Lip and Cleft Palate after Primary Bilateral Cleft Lip Repair

目的 :介绍双侧唇裂 /唇腭裂患者术后鼻唇畸形的Ⅱ期整复方法及效果。方法 :将 5 0例患者按鼻畸形、唇畸形的不同 ,分别采用三种不同的术式治疗。对上唇组织较多者 ,采用鼻底叉形瓣延长鼻小柱 ,上唇创缘直接缝合法 ;对鼻及上唇畸形较轻者 ,采用Noordhoff整复法治疗 ;对鼻唇畸形严重并有上唇过紧者 ,采用前唇组织瓣延长鼻小柱 ,下唇Abb啨瓣旋转修复上唇正中缺损?峁?:5 0例患者中 ,30例Ⅱ期修复后鼻形态正常 ,鼻孔大小对称 ,有良好的鼻堤 ,鼻小柱长度适中 ;恢复了上唇的高度和宽度 ,有明显的人中嵴、唇峰及唇珠 ,上下唇和谐。 11例患者一般。结论 :本文介绍的三种术式适用于不同类型双侧唇裂术后鼻唇畸形的患者。

Objective:To introduce the second repair methods and outcomes of the patients with the secondary deformities after primary repair of the bilateral cleft lip or / and bilateral cleft lip and cleft palate.Methods:Fifty patients with the secondary deeformities may adopt Noordhoff's method of the bilateral cleft lip repair;The patients who have severe nasal and labial deformities and tight upper lip may use advancement of the prolabium into the columella for lengthening,combined with an Abbé flap for upper lip reconstruction when a deficient upper lip is unable to yield donor tissue.Results:Thirty patients of 50 cases have had an obvious Cupid's bow,Cupid's bow peak and the median tubercle, and have recovered the normal nasal configuration, the nostril size, the nostril sill, proper length of the columella and the height and width of the upper lip.Other 11 patients had an improvement for the secondary nasal and labial deformities.Conclusion:The three operative techniques may be used for repairing secondary nasal and labial deformities of the patient with the bilateral cleft lip and bilateral cleft lip and cleft palate after the primary repair of the bilateral cleft lip or/and bilateral cleft lip and cleft palate.