Zhao Tian-Lan, Wu Li-jun, Yu Dao-jiang, Chen Qi, Han Wen-Ya
Department of Plastic and Aesthetic Surgery, The Second Affiliated Hospital, Suzhou University, Suzhou, China.
Ann Plast Surg. 2012 Aug;69(2):161-4. doi: 10.1097/SAP.0b013e318226b4fc.
The lip is a primary aesthetic feature of the human face. Repair of vermilion defects represents a unique challenge to the reconstructive surgeon. The methods of repair are various and have both advantages and disadvantages. Bilateral lip mucosa flaps were applied to the repair of upper vermilion defects, and the effects were observed and reported in this article.
The bilateral lip mucosa flaps were designed. Two reverse triangular flaps were designed on both sides of the upper vermilion defect. These 2 flaps have the common pedicle in the vermilion depression site. Alternatively, a "λ" incision may be used in the wet vermilion. Then, the mucosa flaps were raised, and the dissection was performed between the orbicularis oris muscles and oral mucosa glands. Next, the bilateral mucosa flaps were rotated down 90° and inserted into the "λ" incision to increase the tissue volume of the middle upper lip and deepen the labiogingival sulcus. The common pedicle of the mucosa flaps was formed to the vermilion tubercle, and the incisions were sutured layer by layer.
From 2005 to 2010, the bilateral mucosa flaps procedures were performed on 30 secondary cleft lip patients (bilateral, n=22; unilateral, n=8). Lateral projection measurements of the reconstructive vermilion tubercle showed a mean increase of 149%. Satisfactory results were obtained, both cosmetically and functionally, in all 30 patients. There were minimal perioperative complications. The postoperative scars are not remarkable at all.
The technique is relatively simple. The bilateral lip mucosa flaps provided a versatile and reliable option for the correction of vermilion defects from secondary cleft lip deformities.
唇部是人脸的主要美学特征。修复唇红缺损对整形外科医生来说是一项独特的挑战。修复方法多种多样，且各有优缺点。本文应用双侧唇黏膜瓣修复上唇红缺损，并观察其效果。
设计双侧唇黏膜瓣。在上唇红缺损两侧设计两个反向三角形瓣。这两个瓣在唇红凹陷处有共同的蒂。或者，可在湿唇红处采用“λ”形切口。然后掀起黏膜瓣，在口轮匝肌与口腔黏膜腺之间进行分离。接下来，将双侧黏膜瓣向下旋转90°，插入“λ”形切口中，以增加上唇中部的组织量并加深唇龈沟。将黏膜瓣的共同蒂形成至唇红结节，切口逐层缝合。
2005年至2010年，对30例二期唇裂患者（双侧22例，单侧8例）实施了双侧黏膜瓣手术。重建唇红结节的侧方突出测量显示平均增加了149%。所有30例患者在美容和功能方面均取得了满意的效果。围手术期并发症极少。术后瘢痕根本不明显。
该技术相对简单。双侧唇黏膜瓣为矫正二期唇裂畸形所致的唇红缺损提供了一种通用且可靠的选择。
