Kuna Santhosh Kumar, Srinath N, Naveen B S, Hasan Kamal
Department of Oral and Maxillofacial Surgery, C.K.S. Theja Dental College, Tirupathi, Andhra Pradesh India.
Department of Oral and Maxillofacial Surgery, Krishnadevaraya Dental College, Bangalore, Karnataka India.
J Maxillofac Oral Surg. 2016 Jun;15(2):221-8. doi: 10.1007/s12663-015-0816-z. Epub 2015 Jul 25.
Certain preoperative anatomical features may lead the surgeon to choose one particular incision pattern in preference to another. No one technique of cleft lip repair consistently produces ideal aesthetic and functional results.
This study was conducted to compare the outcomes attained using two different designs of skin incision used for surgical correction of unilateral cleft lip.
Modified Millard's incision and Delaire's functional method techniques were performed and evaluated on 18 patients who received primary unilateral cleft lip repair. Soft-tissue measurements of the lip and nose were recorded preoperatively. Analysis was based on postoperative assessment of the white roll, vermilion border, scar, Cupid's bow, lip length, and nostril symmetry and appearance of the alar dome and base. Chi-square and Fisher exact test, Student t test (two tailed, independent) and Student t test (two tailed, dependent) were used for statistical analysis of study parameters at 5 % level of significance.
Preconceptions that one particular technique was better suited to certain preoperative cleft anatomical forms were not proven statistically. The outcome of our surgical methods was good and suggested quantitative changes with progressive diminution of asymmetry of the cleft and non cleft sides.
Lip length improvement was better in case of modified Millard's incision. The Delaire's functional method of cleft lip repair results in improved nasal symmetry due to correction of the abnormal insertions of the underlying musculature.
某些术前解剖特征可能会使外科医生更倾向于选择一种特定的切口模式而非另一种。没有一种唇裂修复技术能始终如一地产生理想的美学和功能效果。
本研究旨在比较用于单侧唇裂手术矫正的两种不同皮肤切口设计所取得的效果。
对18例接受一期单侧唇裂修复的患者采用改良米勒氏切口和德莱尔功能法技术进行手术并评估。术前记录唇部和鼻部的软组织测量数据。分析基于术后对白色卷唇、唇红缘、瘢痕、丘比特弓、唇长、鼻孔对称性以及鼻翼穹窿和基部外观的评估。采用卡方检验和费舍尔精确检验、学生t检验（双侧，独立）和学生t检验（双侧，相关）对研究参数进行统计学分析，显著性水平为5%。
认为一种特定技术更适合某些术前唇裂解剖形式的先入之见未得到统计学证实。我们手术方法的效果良好，表明随着裂隙侧和非裂隙侧不对称性的逐渐减小，出现了定量变化。
改良米勒氏切口的唇长改善效果更好。德莱尔唇裂修复功能法由于矫正了深层肌肉组织的异常附着，使鼻对称性得到改善。
