Zhu Gefei, Mai Hui
Department of Plastic Surgery, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning Guangxi 530021, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Sep;26(9):1081-3.
To investigate the effectiveness of the mortise-tenon orbicularis oris muscle flap for philtrum column deformity secondary to the unilateral cleft lip repair.
Between January 2009 and August 2011, 43 patients with philtrum column deformity secondary to unilateral cleft lip repair were treated. There were 23 males and 20 females with an average age of 23.6 years (range, 18-31 years). The left philtrum column was involved in 26 cases, and the right side in 17 cases. Cleft lip was repaired with Millard I in 15 cases and with Millard II in 28 cases. The time between cleft lip repair and philtrum column deformity correction was 15-30 years (mean, 21.7 years). The bilateral double orbicularis oris muscle flap was obtained, and then was divided horizontally into two layers. The overlapping suture of the bilateral lower muscle flap was perfomed, and the upper layer muscle was designed into the mortise-tenon orbicularis oris muscle flap and was sutured with contralateral skin.
All incisions healed by first intention. Forty cases were followed up 13.4 months on average (range, 6-34 months). The patients achieved satisfactory effects in bilateral symmetry philtrum column and normal concave shape. At 6 months after operation, significant improvement was observed in 38 cases and no obvious improvement in 2 cases.
The mortise-tenon orbicularis oris muscle flap is a simple operation and can obtain good results in the appearance and function of the upper lip in the correction of philtrum column deformities secondary to the unilateral cleft lip repair.
探讨口轮匝肌榫卯瓣修复单侧唇裂修复术后人中嵴畸形的效果。
2009年1月至2011年8月,治疗43例单侧唇裂修复术后人中嵴畸形患者。男23例,女20例,平均年龄23.6岁(18 - 31岁)。左侧人中嵴畸形26例,右侧17例。唇裂修复采用Millard I法15例,Millard II法28例。唇裂修复至人中嵴畸形矫正时间为15 - 30年(平均21.7年)。获取双侧口轮匝肌瓣,然后水平分为两层。进行双侧下层肌瓣重叠缝合,上层肌瓣设计为口轮匝肌榫卯瓣并与对侧皮肤缝合。
所有切口均一期愈合。40例患者平均随访13.4个月(6 - 34个月)。患者双侧人中嵴对称及正常凹陷形态效果满意。术后6个月,38例改善明显,2例改善不明显。
口轮匝肌榫卯瓣手术操作简单,在修复单侧唇裂修复术后人中嵴畸形中,对上唇外观及功能可取得良好效果。