榫卯型口轮匝肌肌瓣修复单侧唇裂术后继发人中嵴畸形  

APPLICATION OF MORTISE-TENON ORBICULARIS ORIS MUSCLE FLAP FOR PHILTRUM COLUMN DEFORMITY SECONDARY TO UNILATERAL CLEFT LIP REPAIR

作　　者：朱格非[1] 麦慧[1] 

机构地区：[1]广西壮族自治区人民医院整形外科,南宁530021

出　　处：《中国修复重建外科杂志》2012年第9期1081-1083,共3页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的探讨榫卯型口轮匝肌肌瓣修复单侧唇裂术后继发人中嵴畸形的疗效。方法 2009年1月-2011年8月,收治43例单侧唇裂修复术后继发人中嵴畸形患者。男23例,女20例;年龄18～31岁,平均23.6岁。左侧26例,右侧17例。唇裂采用MillardⅠ式修复15例,MillardⅡ式修复28例。唇裂修复术至此次手术时间为15～30年,平均21.7年。术中切取双侧口轮匝肌肌瓣,水平分成上、下两层;双侧下层肌瓣相互重叠缝合,上层肌瓣形成榫卯型结构,缝合于皮下。结果术后患者切口均Ⅰ期愈合。40例患者获随访,随访时间6～34个月,平均13.4个月。双侧人中嵴隆起、对称,人中凹形态接近正常,上唇动态效果满意。术后6个月38例明显改善,2例改善不明显。结论榫卯型口轮匝肌肌瓣手术操作简便,修复单侧唇裂术后继发人中嵴畸形能较好恢复解剖结构,术后获得良好上唇外形和功能。Objective To investigate the effectiveness of the mortise-tenon orbicularis oris muscle flap for philtrumcolumn deformity secondary to the unilateral cleft lip repair.Methods Between January 2009 and August 2011,43 patientswith philtrum column deformity secondary to unilateral cleft lip repair were treated.There were 23 males and 20 females with anaverage age of 23.6 years（range,18-31 years）.The left philtrum column was involved in 26 cases,and the right side in 17 cases.Cleft lip was repaired with Millard I in 15 cases and with Millard II in 28 cases.The time between cleft lip repair and philtrumcolumn deformity correction was 15-30 years（mean,21.7 years）.The bilateral double orbicularis oris muscle flap was obtained,and then was divided horizontally into two layers.The overlapping suture of the bilateral lower muscle flap was perfomed,andthe upper layer muscle was designed into the mortise-tenon orbicularis oris muscle flap and was sutured with contralateralskin.Results All incisions healed by first intention.Forty cases were followed up 13.4 months on average（range,6-34 months）.The patients achieved satisfactory effects in bilateral symmetry philtrum column and normal concave shape.At 6 months afteroperation,significant improvement was observed in 38 cases and no obvious improvement in 2 cases.Conclusion Themortise-tenon orbicularis oris muscle flap is a simple operation and can obtain good results in the appearance and function of theupper lip in the correction of philtrum column deformities secondary to the unilateral cleftlip repair.

关 键 词：唇裂 继发畸形 口轮匝肌肌瓣 人中嵴畸形 

分 类 号：R782.2[医药卫生—口腔医学]