Li Weiwei, Steinbacher Derek M
New Haven, Conn. From Section of Plastic Surgery, Yale University.
Plast Reconstr Surg. 2015 Sep;136(3):353e-361e. doi: 10.1097/PRS.0000000000001560.
Unilateral cleft lip revision may be necessary to address visible scars, unequal anatomical boundaries, vermillion inequities, or some combination thereof. In the setting of more than one stigma, a complete recreation of the defect and repair is necessary. This study anthropometrically evaluates the results of cleft lip revision following conversion to the modified inferior triangle.
A retrospective analysis of patients who underwent cleft lip revision using the modified inferior triangle was included. Standard preoperative and postoperative photographs were obtained and evaluated. Anthropometric points were placed and measurements performed. Results were corroborated by two independent, blinded reviewers (Pearson correlation test), and compared using the paired t test.
Twenty-seven patients were included (mean age, 10.89 years; female, n = 10) over a 35-month period. Intraobserver and interobserver ratios were shown to be reliable. Significant differences (p < 0.05) were seen in the philtrum column height (PCH), hemilabial length (HL), and hemilabial length' (HL') preoperatively. No significant differences (p > 0.05) were noted in the PCH, HL, and HL' postoperatively. Significant changes (p < 0.05) between ΔPCH, ΔHL, and ΔHL' of cleft side and ΔPCH, ΔHL, and ΔHL' of noncleft side were found. Philtral height showed significant changes (p < 0.05) after conversion to the modified inferior triangle. Significant changes (p < 0.05) were found in the philtrum column width and mouth width.
Cleft lip revision is effectively performed using the modified inferior triangle repair, improving the lip appearance with improved anthropometric measures.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
单侧唇裂修复可能是必要的，以解决明显的疤痕、解剖边界不平等、唇红不平等或它们的某种组合。在存在多种瑕疵的情况下，需要对缺损进行完全重建和修复。本研究通过人体测量学评估了采用改良下三角法进行唇裂修复的效果。
纳入对采用改良下三角法进行唇裂修复的患者的回顾性分析。获取并评估标准的术前和术后照片。放置人体测量点并进行测量。结果由两名独立的、不知情的评审员进行验证（皮尔逊相关检验），并使用配对t检验进行比较。
在35个月的时间里纳入了27例患者（平均年龄10.89岁；女性10例）。观察者内和观察者间的比率显示是可靠的。术前人中柱高度（PCH）、半唇长度（HL）和半唇长度'（HL'）存在显著差异（p<0.05）。术后PCH、HL和HL'无显著差异（p>0.05）。发现患侧与非患侧的ΔPCH、ΔHL和ΔHL'之间存在显著变化（p<0.05）。转换为改良下三角法后人中高度显示出显著变化（p<0.05）。人中柱宽度和口宽度也发现了显著变化（p<0.05）。
采用改良下三角修复法可有效进行唇裂修复，通过改进人体测量指标改善唇部外观。
临床问题/证据级别：治疗性，IV级。
