前唇皮下组织瓣在双侧唇裂术后继发畸形修复中的应用  

Secondary correction of deformities of the lip with subdermal soft tissue flaps after bilateral cleft lip repair

作　　者：田孝臣 刘虎仙 吕晓杰 陈俊男 杨超 刘莹 刘会娜 赵亚楠 

机构地区：[1]解放军火箭军总医院整形外科,北京100088

出　　处：《中华医学美学美容杂志》2016年第3期154-156,共3页Chinese Journal of Medical Aesthetics and Cosmetology

摘　　要：目的探讨应用前唇皮下组织瓣，重建口轮匝肌连续性和完整性，修复双侧唇裂继发上唇“口哨”畸形与鼻底凹陷的临床效果。方法选择前唇皮下组织瓣修复双侧唇裂术后继发畸形患者36例。采用前唇上方双侧皮下组织c1瓣、c2瓣修复鼻底凹陷畸形，两侧口轮匝肌a瓣、b瓣向中线对合，重建口轮匝肌连续性，同时前唇下方皮下组织d瓣向下推进形成或再造唇珠。根据“口哨”畸形改善、唇珠形态、双侧伤口瘢痕和患者满意度，采用量化评分法评价手术效果。结果全部患者术后伤口均Ⅰ期愈合，鼻底、唇部形态明显改善，唇珠明显，上唇形态自然。36例患者术后8个月以上随访到23例，5例很满意，16例满意；2例不满意，后经门诊手术局部调整后，患者均较满意。结论前唇上方皮下组织双侧c1瓣、c2瓣及前唇下方皮下组织d瓣，可以改善鼻底凹陷，加强或再造唇珠；两侧口轮匝肌a、b瓣在中线对位缝合可以重建口轮匝肌连续性，上唇形态恢复好，治疗效果确切。Objective To explore a new method to correct nostril-bottom deformities and whis- tle deformity of secondary deformities of bilateral complete cleft lip （BCCL）. Methods Bilateral subdermal soft tissue c flaps and d flap were designed to repair secondary deformities of nostril-bottom and vermilion tubercle in patients with bilateral complete cleft lip （BCCL）. Results The good healing was found in all the cases. No flap necrosis was noted. The result was satisfactory in the 23 patients that had been followed up more than 8 months; 5 were very satisfied with their results, whereas sixteen patients graded their results as good. Conclusions With bilateral subdermal soft tissue c flaps and d flap, nostril bottom deformities and whistle deformities can be corrected with definite and good efficacy.

关 键 词：双侧唇裂 外科皮瓣 唇裂术后继发畸形 口轮匝肌 

分 类 号：R782.21[医药卫生—口腔医学]