双旗形皮瓣矫正双侧唇裂术后前唇部过短过宽畸形  

Correction of shortened and broaden prolabium deformity with double flag-shaped flaps following bilateral cleft lip repair

作　　者：于仁义[1] 刘顺利[1] 陈铭锐[1] 刘本立[1] 卞东会[1] 武铠[1] 

机构地区：[1]济南军区总医院烧伤整复科,济南25003l

出　　处：《中华整形外科杂志》2013年第4期244-247,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探索双侧唇裂术后前唇部过短、过宽畸形矫正的手术方法。方法设计上唇双旗形皮瓣，切除四边形原手术瘢痕皮肤（皮瓣的旗杆部分），切开掀起经鼻孔底部向鼻翼沟伸沿的旗形皮瓣（旗面部分）。牵引唇珠，钝性分离人中上端，形成宽4～6mm创面，将两侧旗形皮瓣，向中央旋转、推进，间断缝合，形成新的鼻底、前唇部。唇珠、唇红部畸形，采用V—Y或z成形术矫正。结果2008年1月至2012年12月于临床应用10例，患者术后前唇部增高4～6mm，从根本上矫正了双侧唇裂术后前唇部过短、过宽引发的上唇畸形；同时矫正了唇珠区凹陷或缺损、人中过宽、人中嵴瘢痕和红唇连续性差等畸形，随访3个月至3年，效果满意。结论上唇鼻底部双旗形皮瓣，操作简单、效果良好，是一种矫正双侧唇裂术后前唇部过短、过宽畸形的方法。Objective To explore the correction for shortened and broaden prolabium deformity following bilateral cleft lip repair. Methods We designed the upper lip double flag-shaped flaps. The quadrilateral original surgical scar （flap flag pole part） was resected and the incision was made along the direction of nasolabial groove at the nostrils bottom to form two flag-shaped flaps （the section of the flag face）. Lip tubercle were tracted and blunt dissection of upper philtrum were performed to form a wound, 4- 6 mm in width. The flag-shaped flaps on both sides were rotated to the central, in order to form a new nasal base and new prolabium, followed by V-Y or Z plasty procedure to correct the defect of tubercle and vermilion. Results 10 cases were enrolled for the clinical application from January 2008 to December 2012. The height of the prolabium was lengthened by 4-6 mm after operation, which fundamentally corrected shortened and broaden prolabium deformity after bilateral cleft lip operation. The procedure can also correct the depression or defect of tubercle, too wide phihrum, phihrum column scar and the deformity of vermilion border continuity. The patients were followed up for a period of 3 months to 3 years with satisfactory results. Conclusion Double flag-shaped flaps of the upper lip at the nostrils bottom is a simple and good surgery method to correct the shortened and broaden prolabium deformity following bilateral cleft lip repair.

关 键 词：唇裂术后继发畸形 双侧唇裂 外科皮瓣 

分 类 号：R7[医药卫生—临床医学] R6