无鼻翼基部切口Millard法功能性修复双侧唇裂的临床研究  

Effect of Millard method without alar basal incision on functional repair of bilateral cleft lip

作　　者：邵敏 张倩 陈炫霖 鲍海 

机构地区：[1]贵州省贵阳市口腔医院口腔颌面外科,贵州贵阳550002

出　　处：《中国现代医学杂志》2016年第19期124-127,共4页China Journal of Modern Medicine

摘　　要：目的探讨应用无鼻翼基部切口Millard法功能性修复双侧唇裂的临床效果。方法在Millard法修复双侧唇裂的基础上,不做绕鼻翼基部的弧形切口,而通过侧唇龈颊沟内的松弛切口,切断鼻翼基部周围异常口轮匝肌附丽,使鼻翼基部得到充分游离。术中的两个叉形瓣做"V–Y"推进封闭双侧鼻底,从而避免在鼻翼基部遗留皮肤瘢痕。红唇修复则采用侧唇矩形红唇肌瓣旋转后,在前唇下方中线缝合重建唇珠形态。结果术后患者两侧唇高、唇长、鼻底宽度和鼻小柱高度与术前比较,经t检验,差异有统计学意义(P<0.05),患者两侧唇高总体水平降低,唇长延长,鼻底宽度缩短,鼻小柱高度增加。术后伤口均一期愈合,无感染裂开,无组织瓣缺血坏死。术后随访患者唇弓形态对称良好,唇红丰满,上唇动态活动下形态自然,鼻翼外形明显改善。但完全性唇裂还存在鼻小柱短小,鼻翼外形塌陷需二期手术。结论应用该方法功能性修复双侧唇裂可获得较好的鼻唇形态。Objective To investigate the functional repair effect of Millard method without alar basal incision in treating bilateral cleft lip. Methods On the basis of the Millard method for repair of bilateral cleft lip without alar incision around the base of the nose, the abnormal orbicularis muscle attachment around the alar base was cut off through the relaxation incision in labiogingival buccal sulcus. In the surgery, two forked flaps were used to block the closure of the bilateral nasal floor by ＂V-Y＂ style to avoid skin scar at alar base. Vermilion flap was rounded and sewed up to reconstruct vermilion tubercle in repairment. Results The overall height of both sides of the lips and nasal bottom width were both decreased, and the lip length and columella height were both increased after surgery（P〈0.05）. All the patients had healing by first intention,without infection, rupture or avascular necrosis. After one year, all the patients had symmetrical labial arch,full vermilion of the lip and perfect shape of nosewing. Conclusions Functional repair of Millard method without alar basal incision is effective in treating bilateral cleft lip.

关 键 词：MILLARD法 功能性修复 双侧唇裂 

分 类 号：R782.2[医药卫生—口腔医学]