Ma Hengyuan, Wang Yongqian, Song Tao, Li Haidong, Wu Di, Zhao Zhenmin, Yin Ningbei
Center for Cleft Lip and Palate Treatment, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Craniofac Surg. 2016 Oct;27(7):1777-1781. doi: 10.1097/SCS.0000000000002935.
Bilateral cleft lip is considered to be the most difficult cleft lip to repair. More and more surgeries are concerned about the reconstruction of orbicularis muscle and the pursuit of philtrum shaping in bilateral cleft lip repair, but most have little success. Years of study on the orbicularis muscle of children with cleft lip resulted in authors' creation of muscle tension line groups theory. Through implementation of this theory, the authors have achieved favorable results in microform cleft lip repair. The authors also applied this concept to bilateral cleft lip repair.
Between January 2010 and December 2014, 31 children with bilateral cleft lip received operations in authors' department, and underwent muscle tension line group reconstruction in accordance with the theory of muscle tension line groups. Two third-party doctors judged postoperative results using a 3-point visual analogue scale.
Twenty-two of the 31 children completed a follow-up 6 months to 1 year after surgery. Most postoperative and follow-up results were satisfactory.
Fully reconstructed muscle tension line groups can not only assist with close fractures, but, for example, also help adduct the nasal alar, and elevate the nasal floor. Furthermore, the surgery can be used to reconstruct the 3-dimensional structure of the philtrum. Ultimately, surgical application of the muscle tension line groups theory proved its feasibility and potential for further development.
双侧唇裂被认为是最难修复的唇裂类型。在双侧唇裂修复中，越来越多的手术关注口轮匝肌的重建以及人中形态的塑造，但多数效果不佳。作者通过多年对唇裂患儿口轮匝肌的研究，创立了肌肉张力线群理论。基于该理论的实施，作者在微小型唇裂修复中取得了良好效果。作者还将这一理念应用于双侧唇裂修复。
2010年1月至2014年12月，31例双侧唇裂患儿在作者所在科室接受手术，并依据肌肉张力线群理论进行肌肉张力线群重建。两名第三方医生采用3分视觉模拟评分法对术后效果进行评判。
31例患儿中有22例在术后6个月至1年完成随访。多数术后及随访结果令人满意。
完全重建的肌肉张力线群不仅有助于骨折闭合，例如，还能帮助鼻翼内收、抬高鼻底。此外，该手术可用于重建人中的三维结构。最终，肌肉张力线群理论在手术中的应用证明了其可行性及进一步发展的潜力。
