长庚法修复单侧不完全性唇裂  

Functional repair of incomplete unilateral cleft lip with Changgeng's method

作　　者：李小林[1] 巫国辉[1] 刘善[1] 曾瑞[1] 夏小平[1] 刘诚[1] 

机构地区：[1]江西省人民医院整形外科,南昌330006

出　　处：《中华医学美学美容杂志》2005年第2期77-79,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的　探讨长庚法功能性修复单侧不完全性唇裂的疗效。方法　应用长庚法修复46例单侧不完全性唇裂。在设计旋转切口时,长庚法与Millard法相似;在设计患侧唇的推进瓣时,应尽量避免鼻翼基底的水平切口,更不宜做绕鼻翼外脚的弧形切口;C唇瓣向外、上旋转与鼻翼基底的口轮匝肌缝合,以提供对鼻翼的支撑及加高鼻堤;鼻底的宽度应参照健侧并通过 C瓣的旋转实现。结果　46 例中,44例的创口Ⅰ期愈合,1例抓伤、1例湿疹致创口Ⅱ期愈合。患侧唇的高度、长度与健侧一致,患侧鼻底宽度适中且有较好的丰满度,鼻翼外脚形态自然,患侧人中嵴较明显,红唇部形态自然、丰满,唇珠微突,鼻小柱形态好。结论　长庚法功能性修复单侧不完全性唇裂,定点简单,操作方便,创伤小,术后能获得良好的鼻唇外形和功能。Objective To explore the effect of Changgeng's method on functional repairing unilateral incomplete cleft lip. Methods Forty-six case of unilateral incomplete cleft lip repaired with Changgeng's method were retrospetively studied. While the rotatory incision of unaffected side was designed, Changgeng's method was similar to the way of Millard. In addition, the horizontalis incision on basis nasi and the arc incision around alae nasi must be avoided as far as possible when the push flap of affected side was designed. The orbicularis oris muscle flap was designed as the 'C' lip flap and rotated upward and outward to be sewn with the orbicularis oris muscle of basis nasi, which could provide extra support for alae nasi and increase the height of agger nasi. The width of basis nasi should be designed in accordance with that of unaffected side and got from the rotation of the 'C' flap. Results In the 46 patients, the wounds were healed one stage except one scratched and one with eczema. The height and width of affected side were symmetric with unaffected side. On affected side, the width and abundance of basis nasi were proper, and the extra peduncle's form of alae nasi looked like natural. The ridge of philtrum was protrudent and the red lip's form was natural and abundant. The lip pearl was protrudent slightly. In addition, the columella nasi's form was good. Conclusions Changgeng's method for functionaly repairing unilateral incomplete cleft lip is simple for designing and performing. Injury could be decreased and the satisfactory form and function of nose and lip could be achieved.

关 键 词：单侧不完全性唇裂 MILLARD法 功能性修复 方法应用 弧形切口 口轮匝肌 Ⅰ期愈合 Ⅱ期愈合 鼻翼 患侧 旋转 推进瓣 形态 人中嵴 红唇部 鼻小柱 设计 基底 健侧 宽度 鼻底 创口 

分 类 号：R782.2[医药卫生—口腔医学]