旋转黏骨膜瓣在两瓣法修复“U”型宽腭裂中的应用  

The application of a rotating mucoperiosteal flap in repairing a"U"type wide cleft palate with two flaps

作　　者：林向上 邓立才 王涛 王倩 LIN Xiangshang;DENG Licai;WANG Tao;WANG Qian(Fuzhou Children's Hospital of Fujian Province,Fuzhou 350005,China)

机构地区：[1]福建省福州儿童医院烧伤整形科,福建福州350005

出　　处：《中国美容整形外科杂志》2023年第4期200-202,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨旋转黏骨膜瓣在两瓣法修复“U”型宽腭裂中的临床疗效。方法自2017—2021年,福建省福州儿童医院烧伤整形科收治13例腭裂患儿,按照两瓣法设计切口线,沿切口线切开,剥离黏骨膜瓣,游离腭大神经血管束,切断腭腱膜,游离并修复腭帆提肌。在缝合口腔侧黏膜时软硬腭交界处有一类似菱形的缺损。将硬腭的一侧骨黏膜瓣向内向后旋转,使裂隙前端的黏骨膜瓣旋转至菱形的缺损处,覆盖修补缺损。结果13例患儿均顺利完成修复。术后无出血、呼吸道梗阻发生。术后随访6~36个月,创口均愈合良好,无腭瘘发生。结论旋转黏骨膜瓣应用在两瓣法修复“U”型宽腭裂,其操作简单,可以减少神经血管束的游离长度及腭瓣对合的张力,黏膜覆盖鼻侧缝合创口更利于愈合。Objective To explore the clinical effect of rotating mucoperiosteal flap in repairing"U"type wide cleft palate with two flaps.Methods The operation was performed under general anesthesia and oral intubation,opened the mouth with an opener.The incision line was designed based on the two flap method.The incision line was cut along the incision line,the mucoperiosteal flap was stripped,the greater palatine neurovascular bundle was freed,the palatal aponeurosis was cut off,and the levator veli palatini muscle was freed and repaired.There was a rhomboid-shaped defect at the junction of the soft and hard palate when the oral mucosa was sutured.The mucosal flap on one side of the hard palate was rotated inward and backward to make the mucoperiosteal flap at the front of the fissure rotate to the rhombus defect,to cover and repair the defect.Results All 13 patients completed the repair successfully.No bleeding or respiratory obstruction occurred after operation.Follow-up for 6-36 months showed that the wounds healed well without palatal fistula.Conclusion The application of a rotating mucoperiosteal flap in the repair of"U"type wide cleft palate with two flaps is simple,which can reduce the free length of the neurovascular bundle and the tension of the palatal flap closure.The mucosal tissue surrounding the nasal suture line is more conducive to healing.

关 键 词：腭裂 黏骨膜瓣 两瓣法 

分 类 号：R782.2[医药卫生—口腔医学]