基于口鼻轮廓线行Ⅰ期单侧唇裂手术  

First stage surgery for repair of unilateral cleft lip based on the design of lip nasal contour line

作　　者：于涛 李永诚 张露[3] 王晓卫 石冰[4] 

机构地区：[1]云南省第三人民医院整形美容科,昆明650011 [2]昆明微笑行动慈善口腔医院口腔颌面外科,昆明650100 [3]昆明医科大学附属延安医院口腔颌面外科,昆明650051 [4]口腔疾病研究国家重点实验室华西口腔医院(四川大学),成都610041

出　　处：《国际口腔医学杂志》2015年第5期503-506,共4页International Journal of Stomatology

摘　　要：目的探讨根据口鼻轮廓线设计并完成单侧唇裂Ⅰ期整复的手术方法。方法利用裂隙侧口鼻弯曲轮廓线为手术切口的唇裂手术方式,对196例Ⅰ期单侧唇裂患者进行口唇畸形和鼻部畸形整体设计和矫正,包括:1)手术切口线设计在口鼻弯曲的轮廓线上,和弯曲轮廓线重叠,易于隐蔽;2)充分地剥离及松解组织畸形的异常附着;3)患侧鼻翼软骨和黏膜向内向上,鼻翼软骨内侧脚向外向下旋转,矫正患侧鼻翼软骨;4)唇部肌肉的重叠或褥式缝合重建患侧人中嵴的高度;5)保持人中嵴皮肤的完整性。观察术后的鼻唇效果和对称性。结果患者的患侧上唇形态、唇峰长短、鼻孔大小、鼻小柱形态、鼻翼形态和鼻底塌陷程度,较术前均有明显改善,鼻唇外形接近于正常外形,术后轮廓线上的瘢痕不明显,整复效果满意。结论根据口鼻轮廓线设计单侧唇裂Ⅰ期整复手术方案,能取得良好外形美观效果。Objective To discussion the methods and clinical efficacy of first repair surgery according to the lip nasal contour line design of unilateral cleft lip. Methods Use of contour line affected side lip nasal to design cleft lip to surgery operative incision and comprehensive repair for lip nasal deformity of 196 patients with first stage unilateral cleft lip, include： 1） operation incision line design in the lip nasal contour line curved, overlapping and bend contours, easily concealed; 2） fully stripping of abnormal attachment tissue deformity; 3） affected side alar cartilage and mucosal inward, outward and downward rotation of the medial foot of alar cartilage, correction of deformities of alar cartilage; 4） the lip muscle overlap or mattress suture reconstruction affected side philtrum crest height; 5） keeping the integrity of philtrum crest skin. Observation of postoperative nasal lip effect and symmetry. Results Patients with ipsilateral upper lip shape, lip peak length, nostril size, the morphology of nasal columella, nose shape and nasal base collapse degree, were significantly improved compared with preoperative, nose and lip shape close to normal shape, postoperative contour line of the sear is not obvious, plastic effect satisfaction.Conclusion According to the lip design and comprehensive repair of can achieve good appearance effect. nasal contour line unilateral cleft lip,can achieve good appearance effect.

关 键 词：单侧唇裂畸形 I期修复 轮廓线设计 综合整体修复 

分 类 号：R782.21[医药卫生—口腔医学]