Yamada Tomohiro, Mori Yoshihide, Minami Katsuhiro, Mishima Katsuaki, Sugahara Toshio
Department of Oral and Maxillofacial Reconstructive Surgery, Okayama University, Japan.
J Craniomaxillofac Surg. 2002 Dec;30(6):337-42. doi: 10.1054/jcms.2002.0320.
There are numerous methods of repairing a cleft lip. In our institution, two methods have been used for primary lip repair, the triangular flap method, and the rotation-advancement plus small triangular flap method. The purpose of this study was to compare postsurgical anthropometric results following these two surgical methods.
Twenty children with a unilateral complete cleft lip, alveolus and palate (UCLAP) were selected for this study. Ten underwent primary lip repair by the triangular flap method (Triangular Group), and the other 10 underwent repair by the rotation-advancement plus small triangular flap method (Rotation Group).
They were documented with a three-dimensional optical scanner, and analysed with computer-aided anthropometric method reported previously (Comput. Methods Programs 58: 159-173, 1999a; J. Cranio-Maxillofac Surg 27: 345-353, 1999b).
The shapes of the nose and nostril were a little better in the Rotation Group. However, in the Rotation Group, differences between good and poor cases were more extreme than in the Triangular Group. The shape of Cupid's bow was good shortly after surgery in the Triangular Group. A good shape of Cupid's bow was also obtained in the Rotation Group, but the improvement was more delayed. On the non-cleft side, the length of Cupid's bow was more extended in the Triangular Group. Certain deformities were common to both groups, such as deviation of the columella and a flattened ala on the cleft side.
Rotation-advancement plus the small triangular flap method was thought to produce somewhat better results, however, further improvements in the technique are needed.
唇裂修复方法众多。在我们机构，两种方法用于一期唇裂修复，即三角瓣法和旋转推进加小三角瓣法。本研究目的是比较这两种手术方法术后人体测量结果。
选取20例单侧完全性唇腭裂（UCLAP）患儿进行本研究。10例采用三角瓣法进行一期唇裂修复（三角瓣组），另10例采用旋转推进加小三角瓣法进行修复（旋转组）。
用三维光学扫描仪记录，并采用先前报道的计算机辅助人体测量方法进行分析（《计算机方法与程序》58：159 - 173，1999a；《颅颌面外科杂志》27：345 - 353，1999b）。
旋转组鼻和鼻孔形状稍好。然而，旋转组中优、差病例之间的差异比三角瓣组更明显。三角瓣组术后不久丘比特弓形状良好。旋转组也获得了良好的丘比特弓形状，但改善更延迟。在非裂侧，三角瓣组丘比特弓长度更延长。两组均存在一些常见畸形，如鼻中隔偏曲和裂侧鼻翼扁平。
旋转推进加小三角瓣法被认为能产生稍好的效果，然而，该技术仍需进一步改进。
