33例颅面裂Tessier分类诊断与治疗体会  

33 cases of craniofacial clefts:experience in diagnosis and treatment with Tessier classification

作　　者：邢新[1] 欧阳天祥[1] 周剑虹[1] 张明利[1] 郭恩覃[1] 

机构地区：[1]第二军医大学附属长海医院整形外科,上海200433

出　　处：《中华整形外科杂志》2006年第4期262-265,共4页Chinese Journal of Plastic Surgery

摘　　要：目的介绍颅面裂的Tessier分类诊断与手术治疗体会。方法按Tessier分类法对33例颅面裂患者进行分类,并根据畸形类型及轻重程度制定手术方案;共施术29例,手术方法包括单纯眶内侧壁截骨与鼻翼软骨修整、局部皮瓣转移、内眦固定、真皮移植、骨移植、组织代用品置入、吻合血管的游离组织瓣移植等。结果33例中属0号颅面裂1例、0-14号颅面裂3例、1号颅面裂1例2、-12号颅面裂2例、3号颅面裂3例、4号颅面裂1例、5/6号复合颅面裂1例、7号颅面裂18例、6/7/8号复合颅面裂2例1、1号颅面裂1例;29例接受手术的患者,术后面部形态明显改善,无并发症发生。结论①Tessier颅面裂分类法有助于发现与主诉体征相伴的其它颅面畸形,对作出全面正确的诊断及制定手术方案具有重要的指导作用。②在Tessier颅面裂中以7号颅面裂较为常见。③Tessier颅面裂有不同的类型,且每一类型的颅面裂又有不同的严重程度,而且不同类型及不同严重程度的颅面裂又可见于同一患者,需根据患者具体情况制定个性化的手术方案。Objective To introduce our experience in diagnosis and treatment of 33 patients with Tessier craniofacial clefts. Methods 33 patients with craniofacial clefts were classified by Tessier classification. According to the type and severity of the clefts, various techniques, from simple local flap transfer to complicated osteotomy and bone grafting, were used to correct the deformity in 29 patients. Results All patients who underwent corrective operation were satisfied with the result, and there were no complications. Conclusious ① Tessier classification is very important for plastic surgeon to find potential craniofacial deformities related to main signs. ②No. 7 cleft is one of most common Tessier craniofacial clefts. ③Each Tessier cleft is unique, therefore, the treatment plans cannot be standardized. Specific corrective operation must be performed on each patient according to the type and severity of the cleft, including simple local flap transfer to complicated osteotomy and bone grafting or distraction osteogenesis.

关 键 词：颅面裂 Tessier分类 诊断 治疗 

分 类 号：R622[医药卫生—整形外科]