改良单侧唇裂整复术临床应用探讨  

Discussion of the clinical application of modified repairment in the unilateral cleft lip

作　　者：李海如 郑健 吴蕾 陆娟 时恩来 张涛 唐梦霓 彭莎莎 

机构地区：[1]江苏省盐城市第一人民医院口腔科,江苏盐城224001

出　　处：《中国美容医学》2016年第3期30-33,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:以Millard法为基础的唇裂手术方法其术后远期效果受到术者、术式、畸形程度等诸多因素的影响,手术效果难以恒定。为此本文对单侧唇裂整复术的手术方式进行了新的探讨。方法:单侧唇裂患者75例,平均手术年龄5个月,包括单侧不完全性唇裂和单侧完全性唇裂。皮肤与肌瓣定点分别设计,患侧鼻小柱点依据健侧鼻孔大小而定,唇部解剖标志自然状态下复位;肌瓣设计以Millard法为主并对其进行改良,其健侧鼻小柱定点移至患侧鼻小柱根部,不行患侧鼻底下的切口设计,对患侧口轮匝肌进行充分地分离,将其与健侧口轮匝肌相对位缝合。结果:上唇解剖标志自然,上下唇比例协调,组织充足;人中凹存在,皮肤瘢痕明显减少;唇沟部分自然并与邻区相连,同时为二期手术创造了良好条件,利于再次手术;无上唇过紧现象,手术效果较为满意。结论:研究提示按新的定点和设计提出的手术方案,是一种较理想的修复单侧唇裂的新方法,对于单侧唇裂不同畸形程度的患者均可适用。Objective The long-term effect after the operation on basis of Millard method for cleft lip surgery is affected by surgeons,surgical method and degree of deformity and so many factors. The operation effect is difficult to be constant.This paper discussed the surgical method of the repair of the unilateral cleft lip. Methods 75 cases of patients with unilateral cleft lip, whose mean operative age was 5 months.The cases included unilateral incomplete cleft lip and unilateral complete cleft lip.We respectively design skin and muscle flap cite.The ipsilateral nasal columella depended on the normal side of the nose size.Labial anatomic marks replaced under natural state.Design to muscle flap mainly based on the method of Millard carried it on the improvement that move the health side of nasal columella into the affected side.Not to make incision under the affected side of nose and fully separate the ipsilateral orbicularis muscle was to suture with contralaeral orbicularis muscle in relative position. Results Anatomic landmarks were natural in the upper lip and can coordinate with the lower lip.There is adequate tissue.There was a concave. The skin scar reduced significantly. Lip sulcus connected with its adjacent naturally.All these created good conditions for the second operation.There is no tight phenomenon in the upper lip.The operational effect was satisfactory. Conclusion The study suggests that the proposed operational scheme according to the new design is ideal for patients with unilateral cleft lip with different degree of deformity.

关 键 词：单侧唇裂 整复 改良 MILLARD法 

分 类 号：R782.2[医药卫生—口腔医学]