口轮匝肌部分劈开法在唇裂继发畸形人中嵴重建中的应用  

Orbicularis oris partial splitting technique in reconstruction of philtrum column for secondary deformity after cheiloplasty

作　　者：李昊[1,2] 侴海燕[1,2] 

机构地区：[1]郑州大学人民医院 [2]河南省人民医院整形外科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2013年第9期847-848,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省科技攻关项目(132102310188)

摘　　要：目的应用口轮匝肌部分劈开并横褥式缝合的方法重建人中嵴,以提高唇裂继发畸形手术效果。方法 32例唇裂术后继发人中嵴畸形患者,根据上唇畸形情况按照MillardⅡ式设计手术切口或作直线瘢痕两侧梭形切口,全层切开上唇皮肤,创缘两侧作皮肤、肌肉间锐性分离,必要时切断鼻小柱基底部轮匝肌,行轮匝肌非全层劈开,两侧肌肉作横褥式缝合以抬高人中嵴。术后6个月评价手术效果。结果 32例均一期愈合;上唇延长,双侧人中嵴基本对称,人中凹较明显;唇、鼻外形满意,口轮匝肌运动时各部分协调。结论本手术方法较大程度保留了一期术后口轮匝肌的连续性,是唇裂继发畸形人中嵴重建的一种简单、有效方法。Objective To improve the effect of secondary deformity surgery by orbicularis oris partial splitting technique and transverse mattress suture in reconstruction of the philtrum column. Methods According to the deformity of the upper lip, 32 patients received incision on the basis of Millard II or fusiform incision on both sides of longitudinal incision scar, followed with full-thickness incision of upper lip skin and sharp separation of the skin and muscle on both sides of the wound edge. If necessary, orbicular muscle on the base of nasal columella was cut and received non-full-thickness splitting, and then the muscles on both sides underwent transverse mattress suture to raise philtrum column. The effect was evaluated after 6 months. Results All these 32 cases were with primary healing. The upper lip was extended, the bilateral philtrum column was substantially symmetric, and the philtrum concave was obvious. The shapes of lip and nose were fine. The orbicularis oris functioned well. Conclusion This method retains the continuity of orbicularis oris. It is a simple and effective technique in the reconstruction of philtrum column for secondary deformity after cheiloplasty.

关 键 词：唇裂 轮匝肌 人中嵴 

分 类 号：R782.21[医药卫生—口腔医学]