单侧唇裂术后鼻唇畸形的修复技术

The repair of the secondary deformities of the unilateral cleft lip and nose

目的 探讨单侧唇裂术后鼻唇畸形的手术方法 ,探讨其病理解剖特点 ,以寻求治疗该病症状群的针对性技术。方法 通过鼻翼软骨外侧脚交叉转位、移位 ,结合硅胶假体或ePTFE的应用 ,成形鼻尖、鼻翼 ;将鼻小柱基部与裂侧鼻翼缝合建立联系 ,以矫正鼻小柱、裂侧鼻翼和鼻孔的变形 ;利用初次手术的瘢痕瓣 ,结合局部口轮匝肌 ,成形裂侧人中嵴 ;红唇口轮匝肌束状瓣重叠缝合 ,结合皮肤黏膜Z - plasty ,成形唇珠 ,矫正红唇畸形。 结果 本组 32例 ,2 8例具有通常临床表现者效果好 ,4例 (12 .5 % )效果差。该 4例存在白唇、红唇组织量严重不足。结论 应用此方法可以治疗具有通常临床表现的单侧唇裂术后鼻唇畸形 。

Objective To analyze the operative techniques for the repair of the secondary deformities of the unilateral cleft lip and nose. Methods The normal-shaped nasal tip and ala is achieved by the rotation and transposition of the lateral crus of the ala cartilage with silicone or ePTFE implants. The ala base of the cleft-side is sutured to the base of the columella to correct the deformed columella, ala and nostril. The philtral ridge is constructed by the local muscle flap of orbicularis oris and the scar of primary surgery. The vermilion is formed by a bundle of orbicularis oris and a Z-plasty on the mucosa of lip. Results In all 32 cases, 28 cases got good results, whereas 4 cases are unsatisfied because of the insufficient amount of lip tissue. Conclusion The method here is indicated for the common secondary lip and nose defects, but it is not suitable for the patients without enough amount tissue of lip.