The cleft lip nasal deformity accounts for 84% of nasal deformities, which is one of the most common diseases in plastic surgery. The Unilateral cleft lip nasal deformity ,which has a high incidence,had many treatment...The cleft lip nasal deformity accounts for 84% of nasal deformities, which is one of the most common diseases in plastic surgery. The Unilateral cleft lip nasal deformity ,which has a high incidence,had many treatments but not very effective.In this article, we will focus on the repair of unilateral cleft lip nasal deformity, embryology and etiology, anatomy and pathology, classification, preoperative evaluation and repair timing strategies, surgical goals and surgical techniques, postoperative care and effect evaluation . I hope to bring some useful information for clinicians to further guide clinical work.展开更多
Background The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of pat...Background The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of patients with bilateral cleft lip nasal deformity still require columellar lengthening and nasal correction and philtrial construction. This study aimed to provide a new method based on the forked flap to improve the final appearance of these patients. Methods A technique to correct this deformity is described. This consists of （1） a newly modified forked flap including the orbicularis oris muscle and nasalis muscle along the whole flap for columellar lengthening, （2） a reverse V shaped flap from the lower portion of the columella and the prolabium for normal size phitrum construction, （3） inserting the vermilion portion of the forked flap and advancing the nasal floor medially and anteriorly to lengthen and maintain the nasal septum side of the columella for proper tip positioning, （4） open rhinoplasty, allowing definitive repositioning of the lower lateral cartilages, （5） reconstruction of the orbicularis orismuscle as required, and （6） the flaring nostril floor advancing medially and constructing the sill. Results This technique was applied to 15 cases of secondary bilateral cleft lip nasal deformity. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the height of the prolabium was added with normal size philtrial dimensions. Conclusions This method makes maximum use of the tissue containing the scar in the lip and limits tissues in the lower portion of the columella and the prolabium for adequate columella elongation and reconstruction with normal size philtrial dimensions. It is a very reasonable and useful method in correction of secondary bilateral cleft lip nasal deformities.展开更多
目的:探讨先天性单侧唇裂修复术时,同期行鼻畸形矫正的临床效果,最大限度地减少唇裂术后遗留鼻畸形。方法:67例患者,年龄3月到四岁半,用iM l l ardⅠ或Ⅱ或改良Ⅱ式等手术方法基础上同时利用唇裂手术切口入路行鼻小柱、鼻翼基部肌束松解...目的:探讨先天性单侧唇裂修复术时,同期行鼻畸形矫正的临床效果,最大限度地减少唇裂术后遗留鼻畸形。方法:67例患者,年龄3月到四岁半,用iM l l ardⅠ或Ⅱ或改良Ⅱ式等手术方法基础上同时利用唇裂手术切口入路行鼻小柱、鼻翼基部肌束松解,大翼软骨松解、复位、固定,术后配合佩戴唇裂专用硅胶鼻模6月～1年维持鼻形态。结果:随访6个月～5年,效果良好者为53例,占79.1%。结论:在单侧唇裂整复的同期行鼻畸形的矫正,不增加新的切口,却能取得较满意的临床效果;且早期鼻畸形的消除和减轻,对于患儿长期的心理健康发育是非常有益的。展开更多
文摘The cleft lip nasal deformity accounts for 84% of nasal deformities, which is one of the most common diseases in plastic surgery. The Unilateral cleft lip nasal deformity ,which has a high incidence,had many treatments but not very effective.In this article, we will focus on the repair of unilateral cleft lip nasal deformity, embryology and etiology, anatomy and pathology, classification, preoperative evaluation and repair timing strategies, surgical goals and surgical techniques, postoperative care and effect evaluation . I hope to bring some useful information for clinicians to further guide clinical work.
文摘Background The columella, nasal tip, lip relationship in the bilateral cleft lip nasal deformity remains a great challenge for plastic surgeon. An esthetically satisfying result is difficult to obtain. A subset of patients with bilateral cleft lip nasal deformity still require columellar lengthening and nasal correction and philtrial construction. This study aimed to provide a new method based on the forked flap to improve the final appearance of these patients. Methods A technique to correct this deformity is described. This consists of （1） a newly modified forked flap including the orbicularis oris muscle and nasalis muscle along the whole flap for columellar lengthening, （2） a reverse V shaped flap from the lower portion of the columella and the prolabium for normal size phitrum construction, （3） inserting the vermilion portion of the forked flap and advancing the nasal floor medially and anteriorly to lengthen and maintain the nasal septum side of the columella for proper tip positioning, （4） open rhinoplasty, allowing definitive repositioning of the lower lateral cartilages, （5） reconstruction of the orbicularis orismuscle as required, and （6） the flaring nostril floor advancing medially and constructing the sill. Results This technique was applied to 15 cases of secondary bilateral cleft lip nasal deformity. All the flaps took without signs of partial necrosis. In all cases, the nasal tip was projected forward with adequate columella elongation, and the height of the prolabium was added with normal size philtrial dimensions. Conclusions This method makes maximum use of the tissue containing the scar in the lip and limits tissues in the lower portion of the columella and the prolabium for adequate columella elongation and reconstruction with normal size philtrial dimensions. It is a very reasonable and useful method in correction of secondary bilateral cleft lip nasal deformities.
文摘目的:探讨先天性单侧唇裂修复术时,同期行鼻畸形矫正的临床效果,最大限度地减少唇裂术后遗留鼻畸形。方法:67例患者,年龄3月到四岁半,用iM l l ardⅠ或Ⅱ或改良Ⅱ式等手术方法基础上同时利用唇裂手术切口入路行鼻小柱、鼻翼基部肌束松解,大翼软骨松解、复位、固定,术后配合佩戴唇裂专用硅胶鼻模6月～1年维持鼻形态。结果:随访6个月～5年,效果良好者为53例,占79.1%。结论:在单侧唇裂整复的同期行鼻畸形的矫正,不增加新的切口,却能取得较满意的临床效果;且早期鼻畸形的消除和减轻,对于患儿长期的心理健康发育是非常有益的。
