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单侧唇裂修复术中鼻唇部分向上推进可预防术后唇过长。

Upward Advancement of the Nasolabial Components at Unilateral Cleft Lip Repair Prevents Postoperative Long Lip.

作者信息

Matsunaga Kazuhide, Sasaguri Masaaki, Mitsuyasu Takeshi, Ohishi Masamichi, Nakamura Norifumi

出版信息

Cleft Palate Craniofac J. 2016 May;53(3):e71-80. doi: 10.1597/14-272. Epub 2015 Mar 20.

Abstract

OBJECTIVE

To prevent the occurrence of postoperative long lip, longitudinal postoperative changes in nasolabial forms of patients with unilateral cleft lip who underwent primary lip repair with or without upward advancement of the nasolabial components were compared.

PATIENTS

Forty-three subjects (24 unilateral cleft lip and palate [UCLP] and 19 unilateral cleft lip solely, and cleft lip and alveolus [UCL/UCLA]) who underwent primary lip repair with upward advancement of the nasolabial components (NA group) and 30 subjects (16 UCLP and 14 UCL/UCLA) without upward advancement (LA group) were enrolled.

OUTCOME MEASURES

Postoperative photos taken at 1 and 6 months and at 1, 2, and 3 years were used for measuring the heights of the nasal alar base (NBH), the columellar base (CBH), Cupid's peak (CPH), and the upper lip (ULH). The ratios of these measurements between the affected and unaffected sides were calculated in both groups.

RESULTS

In the LA group, the 3-year postoperative all-items ratios of UCLP were significantly larger than those at 1 month postoperatively, demonstrating drooping of the nasolabial tissues in the affected side (all P < .01). Furthermore, the 3-year postoperative CPH and ULH ratio of UCL/UCLA was significantly larger than that at 1 month postoperatively, demonstrating the long lip (P < .01). In the NA group, the NBH, CBH, and CPH ratios of both UCLP and UCL/UCLA did not show significant differences between 1 month and 3 years postoperatively.

CONCLUSION

Upward advancement of the nasolabial components prevents postoperative long lip.

摘要

目的

比较单侧唇裂患者在进行一期唇修复术时,采用或不采用鼻唇结构向上推进的方法,术后长唇的发生率以及鼻唇形态的纵向术后变化。

患者

纳入43例患者(24例单侧唇腭裂[UCLP],19例单纯单侧唇裂以及唇裂合并牙槽突裂[UCL/UCLA]),他们接受了鼻唇结构向上推进的一期唇修复术(NA组),以及30例未进行向上推进的患者(LA组,16例UCLP和14例UCL/UCLA)。

观察指标

术后1个月、6个月以及1年、2年和3年拍摄的照片用于测量鼻翼基底高度(NBH)、鼻小柱基底高度(CBH)、唇峰高度(CPH)和上唇高度(ULH)。计算两组患侧与健侧这些测量值的比率。

结果

在LA组中,UCLP患者术后3年所有项目的比率显著大于术后1个月时,表明患侧鼻唇组织下垂(所有P <.01)。此外,UCL/UCLA患者术后3年的CPH和ULH比率显著大于术后1个月时,表明出现长唇(P <.01)。在NA组中,UCLP和UCL/UCLA患者的NBH、CBH和CPH比率在术后1个月和3年之间没有显著差异。

结论

鼻唇结构向上推进可预防术后长唇。

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