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作 者:翦新春[1] M.M.A.Miqdadi 陈顺金[1] 郭峰[1] 雷荣昌[1]
机构地区:[1]中南大学湘雅医院、中南大学湘雅口腔医学院口腔颌面外科,长沙410008
出 处:《中华医学美学美容杂志》2007年第4期207-210,共4页Chinese Journal of Medical Aesthetics and Cosmetology
摘 要:目的介绍口轮匝肌复位重建在单侧唇裂继发畸形修复中的效果。方法对采用直线缝合法修复的唇裂患者,在行继发畸形修复中,选Millard旋转推进法设计皮肤切口,切开皮肤,将裂隙的健、患两侧的口轮匝肌进行解剖,在健侧,分离口轮匝肌达正常侧人中嵴处;在裂隙侧,将口轮匝肌从皮肤下解剖达10mm;在口腔裂隙的健侧从鼻棘,裂隙侧从鼻翼基部,将口轮匝肌从黏膜下分离出来。使用透明的尼龙线缝合肌肉。将裂隙健、患侧分离的口轮匝肌每侧水平分成4束,互相交叉缝合,然后缝合皮肤。结果术后患侧鼻孔大小、对称性、鼻小柱长度、鼻小柱的位置、患侧人中嵴、患侧唇峰、唇珠、人中凹、鼻尖的高度、突度的变化,术后均近似正常,近期效果满意。结论利用口轮匝肌的重建来修复单侧唇裂继发畸形,以恢复正常上唇正中解剖结构及对称的鼻孔大小,是一种有用的方法。Objective To introduce the effect of muscle reconstruction in secondary repair of the unilateral cleft lip, Methods Patients with the unilateral cleft lip repair used the straight line suture were selected for secondary repair of the unilateral cleft lip. Millard's skin incision was designed and the skin was incised. The skin dissected from the underlying orbicularis muscle on both the medial and the lateral sides of the cleft. Laterally, the skin was dissected from the orbicularis about 10 ram. The muscle was separated from the underlying suhmueosa and mueosa and also from the nasal spine medially and from the alar base region, The mueosal repair was then performed with absorbable suture. The medial and lateral orbicularis muscle flaps were split transversely into four muscle slips and suture with each other, respectively. Skin closure was then performed with clear nylon suture using horizontal mattress sutures to ensure skin eversion. Results The postoperative effects shown that the size of the nostril was symmetric with unaffected side. The length and position of the column had been recovered normally. The height and protrusion of the nasal tip were proper and natural. Patients maintained a neophiltral column with a philtral dimple and the red lip's form was natural and abundant. The lip pearl was protrudent slightly. Conclusion The technique to utilize muscle construction in secondary deformities after the unilateral cleft lip repair is very useful for recovering normal anatomic constructures and functions of the upper lip and nose.
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