Yuzuriha Shunsuke, Mulliken John B
Boston, Mass. From the Department of Plastic Surgery, Children's Hospital and Harvard Medical School.
Plast Reconstr Surg. 2008 Nov;122(5):1485-1493. doi: 10.1097/PRS.0b013e31818820bc.
Whatever method of closure, a cleft lip scar extends along the full labial height. A smaller scar is possible in repair of limited forms of incomplete cleft lip. This retrospective study was undertaken to define the subgroups of lesser-form cleft lip, describe technical alternatives, and review results of repair.
The senior author's (J.B.M.) registry was searched for patients with lesser-form cleft lip, defined by the extent of vermilion-cutaneous dysjunction as either minor-form, microform, or mini-microform. Techniques for repair of these three anatomical variants were examined and the revisions were analyzed.
Of 393 patients with unilateral incomplete cleft lip, 59 lesser-form variants were identified. Minor-form clefts (n = 20), defined as a defect extending 3 mm or more above the normal Cupid's bow peak, were repaired by rotation-advancement. Microform clefts (n = 28), defined as a vermilion-cutaneous notch less than 3 mm above the normal peak, were corrected by double unilimb Z-plasty. Mini-microform clefts (n = 11), defined as a disrupted vermilion-cutaneous junction without elevation of the bow peak, were repaired by vertical lenticular excision. Primary nasal correction was necessary in all minor-form and microform types and in some mini-microform types. In all three lesser-forms, the rate of nasolabial revision was relatively low in comparison with that for unilateral complete cleft lip.
The extent of disruption at the vermilion-cutaneous junction defines minor-form, microform, and mini-microform cleft lip. These anatomical designations determine the method of nasolabial repair and correlate with types and frequency of revision.
无论采用何种闭合方法，唇裂瘢痕都会沿着整个唇部高度延伸。对于有限形式的不完全性唇裂进行修复时，有可能形成较小的瘢痕。本回顾性研究旨在确定较轻形式唇裂的亚组，描述技术选择，并回顾修复结果。
在资深作者（J.B.M.）的登记册中搜索较轻形式唇裂患者，根据唇红-皮肤分离程度将其定义为轻度、微小或极小-微小形式。检查了这三种解剖变异的修复技术并分析了修复情况。
在393例单侧不完全性唇裂患者中，识别出59例较轻形式的变异。轻度唇裂（n = 20）定义为缺损延伸至正常丘比特弓峰上方3 mm或更多，采用旋转推进法修复。微小唇裂（n = 28）定义为唇红-皮肤切迹在正常峰上方小于3 mm，通过双侧单臂Z成形术矫正。极小-微小唇裂（n = 11）定义为唇红-皮肤交界处中断且弓峰无抬高，采用垂直椭圆形切除术修复。所有轻度和微小唇裂类型以及一些极小-微小唇裂类型均需要进行一期鼻矫正。与单侧完全性唇裂相比，在所有这三种较轻形式中，鼻唇修复的翻修率相对较低。
唇红-皮肤交界处的破坏程度定义了轻度、微小和极小-微小唇裂。这些解剖学特征决定了鼻唇修复方法，并与翻修类型和频率相关。
