Sumiya N, Ito Y, Otani K, Hayakawa O, Takano K, Ishii M
Department of Plastic and Reconstructive Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Japan.
Ann Plast Surg. 2001 Apr;46(4):369-74. doi: 10.1097/00000637-200104000-00003.
The complete lip alveolus and cleft palate is the most difficult of all bilateral clefts to treat because of the deformity of and tissue insufficiency in the prolabium. A bilateral concomitant procedure is impractical for treatment of this condition because of the problems that have to be resolved postoperatively, including a short columella, a lack of philtrum, labial horizontal and vertical insufficiency, and vermilion and alveolar vestibulum insufficiency. A two-stage procedure called the transformation method has been developed to circumvent these problems, and the authors present it here. With this method one side is closed completely using the maximum amount of tissue available. Concomitantly, incomplete closure is performed on the other side. The result at the end of the first stage of the procedure is a condition approximating unilateral incomplete closure. The results were obtained from 6 patients who underwent complete bilateral closure and were followed for at least 2 years with satisfactory results.
完全性唇牙槽突及腭裂是所有双侧腭裂中最难治疗的，因为前唇存在畸形且组织不足。由于术后必须解决的问题，包括鼻小柱短、人中缺失、唇部水平和垂直方向组织不足以及唇红和牙槽前庭组织不足，双侧同期手术治疗这种情况是不切实际的。已开发出一种名为转换法的两阶段手术来规避这些问题，作者在此介绍该方法。使用这种方法时，一侧利用可用的最大量组织进行完全封闭。与此同时，另一侧进行不完全封闭。手术第一阶段结束时的结果是接近单侧不完全封闭的状态。结果来自6例接受双侧完全封闭手术且随访至少2年的患者，结果令人满意。
