单侧完全性唇裂鼻畸形一期整复初步评价  

Preliminary evaluation of one-stage restoration of unilateral complete cleft lip nasal deformity

作　　者：令狐清溪[1] 张斌鹏 孟兵[1] Linghu Qingxi;Zhang Binpeng;Meng Bing(Department of Stomatology,First Hospital of Shanxi medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院口腔科,太原030001

出　　处：《山西医药杂志》2018年第21期2514-2516,共3页Shanxi Medical Journal

基　　金：山西省科技攻关项目(20150313010-6)

摘　　要：目的探讨应用罗慧夫(Noordlhoof)改良旋转推进修复术修复单侧完全唇裂并同期矫正鼻畸形的临床效果。方法单侧唇裂采用Noordlhoof改良旋转推进修复术,鼻畸形一期矫正,手术方法参考Noordlhoof方法及Sommerland;不再设计患侧鼻底及鼻翼基部水平切口,改为充分分离错位的患侧口轮匝肌,使其与健侧复位后的口轮匝肌对位缝合;鼻畸形修复不采用Tajima切口,通过唇裂原有切口C瓣切口潜行解剖鼻小柱及鼻尖部和健侧鼻翼、通过患侧鼻翼基部切口分离患侧鼻翼软骨,将其与对侧上鼻翼软骨及皮肤悬吊固定,矫正鼻翼塌陷。自2015年1月至2016年10月,采用本法矫正单侧完全唇裂及鼻畸形患者11例。结果本组11例患者切口均一期愈合。经1～24个月随访,上唇、人中嵴解剖形态自然,动态和静态效果良好,鼻畸形得到明显改善。结论应用罗慧夫改良旋转推进修复术修复单侧完全唇裂并同时矫正鼻畸形,是一种综合修复单侧唇裂的良好方法。Objective To investigate the clinical effects of a Noordlhoof-modified rotation-advancement repair technique.Methods An improved Noordlhoof rotation-advancement technique incorporating a simultaneous correction of nasal deformity was performed in patients with unilateral complete cleft lip,referring to Noordlhoof and Sommerland surgical method for details.The aclinic incision of nose floor and alar base on cleft side was abandoned.Instead,the cleft side malposed orbicularis oris muscles were fully separated and sutured with repositioned contralateral orbicularis oris muscles.Tajima incision was not used for nasal deformity repair.Alternatively,by stealth dissecting columella,nasal tip and the non-cleft side ala nasi through the original flap C incision,and by dissecting the cleft side alar cartilage through an alar base incision,the cleft side alar cartilage were sling fixed to the opposite upper alar cartilage and skin to correct nose collapse.From January 2015 to October 2016,11 patients with unilateral complete cleft lip and nasal deformity received this operation and follow-up measurements.Results The 1~24 month follow-up estimation revealed satisfying outcomes.The incisions healed at the first stage in all patients.The upper lips and philtrum ridges obtained normal anatomical form and good dynamic and static effects.The nasal malformations were improved obviously.Conclusion It is a good comprehensive method to repair unilateral complete cleft lip by using a Noordlhoof-modified rotation-advancement technique and primary rhinoplasty.

关 键 词：唇裂 鼻畸形 修复外科手术 

分 类 号：R782.2[医药卫生—口腔医学]