不完全型Tessier3号颅面裂手术矫治三例  

Surgical treatment for incomplete Tessier No. 3 craniofacial cleft： report of three cases and review of literature

作　　者：安金刚[1] 马莲[1] 周治波[1] 王智[1] 

机构地区：[1]北京大学口腔医学院·口腔医院口腔颌面外科,100081

出　　处：《中华口腔医学杂志》2012年第3期164-168,共5页Chinese Journal of Stomatology

摘　　要：目的 初步总结和分析不完全型Tessier 3号颅面裂的临床诊治.方法 2009至2010年北京大学口腔医学院·口腔医院口腔颌面外科共收治3例不完全型Tessier 3号颅面裂患者,均为男性,年龄分别为2、3和12岁.术前行CT检查明确局部骨缺损以及骨性泪道系统的情况.手术采用van der Meulen颊部旋转推进瓣和眶下畸形区域“Z”字瓣,术中重点悬吊错位的内眦韧带.术后1周和复查时评价手术效果.结果 3例患者术后面部伤口1周拆线,均Ⅰ期愈合.6 ～ 10个月复查,面部瘢痕不明显,内眦角外形、高度及睑裂长度与健侧基本一致.结论 本组采用软组织延长技术结合内眦韧带悬吊矫治不完全型Tessier 3号颅面裂,手术效果良好,畸形未见复发.Objective To primarily assess the surgical technique to correct incomplete Tessier No.3 craniofacial cleft.Methods From 2009 to 2010,3 male patients with incomplete Tessier No.3 craniofacial clefts were treated. Preoperative CT examination of each patient was performed and the bony defect was evaluated.In the operation,van der Meulen rotation and advancement flap of the cheek and regional Z-plasty were used and the medial canthal ligament was repositioned. Results One week after the operation,the sutures were removed and the facial incision healed well.The facial scar was not obvious 6-10 months after operation.The shape of medial canthal angle was acceptable,and the height of the medial canthal angle and the length of the palpebral fissure of both sides were symmetrical. The clinical results were satisfactory.Conclusions For the incomplete Tessier No.3 craniofacial cleft,surgical treatment is mainly focused on the deformities of inner canthus and nasal alae. Medial canthal ligament reposition is the key procedure for correction of the medial canthal deformity and surgical results are stable and reliable.

关 键 词：颌面畸形 外科 整形 面斜裂 

分 类 号：R782.2[医药卫生—口腔医学]