完全性双侧唇裂鼻唇畸形的早期同期修复  

Synchronous correction of lip and nasal deformity in complete bilateral cleft lip

作　　者：郭家妍[1] 王玉新[1] 郭澍[1] 

机构地区：[1]中国医科大学附属第一医院整形外科,沈阳110001

出　　处：《中华整形外科杂志》2015年第5期324-326,共3页Chinese Journal of Plastic Surgery

摘　　要：目的探讨双侧唇裂鼻唇畸形进行同期修复的手术方法，并评价其效果。方法本组共29例，均为完全性双侧唇裂，灵活应用Mulliken手术方法进行鼻唇畸形的同期修复手术，根据亚裔人种特点设计，人中瓣长度6～7mm，鼻小柱与唇交界处宽度3～4mm，两侧唇峰间距为4～5mm。于人中瓣两侧划出点状的皮瓣，去除表皮后推进侧方皮瓣皮下，形成人中嵴。在侧方唇瓣定出两侧唇峰点，向上至鼻底划线。广泛分离两侧唇瓣，再造弓背曲线和唇珠。充分分离并重新缝合定位鼻翼软骨，抬高鼻尖，形成鼻底，延长鼻小柱，缩窄鼻宽度。结果术后患者伤15均为一期愈合，术后随访6个月至6年，所有患者上唇瘢痕均不明显，人中形态自然，人中嵴存在，红唇形态满意，唇珠存在，无明显红唇凹陷及口哨畸形。患者鼻小柱无明显短缩，鼻翼及鼻尖塌陷明显改善，前颌骨明显后退。结论灵活应用Mulliken手术方法并结合亚裔人特点进行双侧唇裂鼻唇畸形的同期修复，术后效果满意。Objective To investigate the technique and its therapeutic effect of synchronous correction of lip and nasal deformity in complete bilateral cleft lip. Methods 29 patients with complete bilateral cleft lip underwent synchronous correction of lip and nasal deformity with the modified Mulliken method for Asians. The philtral flap was 6 -7 mm in length, and 3 -4 mm in width at the collumellarlabial junction. The distance between the peaks of cupid＇ s bow was 4 - 5 ram. The bilateral edge of philtral flap was de-epithelialized and advanced to form phihrum column. The lateral lip was advanced to the medial site, and the central vermilion tubercle was constructed with the bilateral vermilion-mucosal flap. Through the Mar rim incision, the displaced cartilage was dissected and rcpositioned to raise the nasal tip. The follow-up period was 6 months to 6 years. Results Satisfactory results were achieved in all patients. The reconstructed upper lip had invisible scar with natural phihrum and column. The vermilion had good appearance with tubercle. The length of nasal column was not decreased and depression of nasal tip and alar was greatly improved. Conclusions Our modified Mulliken method is effective in synchronous correction of lip and nasal deformity in bilateral cleft lip.

关 键 词：双侧唇裂 鼻唇畸形 同期修复 

分 类 号：R782.2[医药卫生—口腔医学]