Hernández-Díaz C, Albert Cazalla A, Parri Ferrandis F J, Correa Jorquera J, Rubio-Palau J
Servicio de Cirugía Pediátrica. Hospital Universitario de Burgos.
Servicio de Cirugía Pediátrica. Hospital Universitari Sant Joan de Déu. Barcelona.
Cir Pediatr. 2017 Apr 20;30(2):111-116.
Isolated cleft lip is the mildest form of the cleft lip and palate spectrum; however those patients are often treated with the same surgical techniques that are used for the more severe cases (advancement-rotation flaps, quadrangular flaps). Meara's cheiloplasty technique may be a less aggressive option for lip repair in isolated cleft lip or whenever the gap between labial segments is not wide.
All children that had their cleft lip repaired following Meara's cheiloplasty between May 2014 and December 2015 were retrospectively reviewed. Duration of the surgical procedure, time to hospital discharge and complications were noted. Aesthetic results were evaluated in terms of lip height and symmetry, nose shape and symmetry, and scar appearance.
Thirteen patients underwent Meara's cheiloplasty during this period. The average age was 6.11 months (5 to 12 months). A primary rhinoplasty was done at the same time in case of nasal asymmetry. Duration of the lip repair averaged 85 minutes. Oral feeding was started 4 hours after the procedure; bottle-feeding was withheld for 2 weeks postoperatively, as our protocol recommends after other lip repair techniques. In all 13 cases the result was a symmetrical, adequately high upper lip and a well-balanced nose, except for one case of lip scar retraction that was solved with triamcinolone infiltration. There were no other intra or postoperative complications.
Meara's cheiloplasty corrects small or moderate gap cleft lip (usually cleft lip without cleft alveolus). Benefits over other teccniques are a shorter procedure and less geometric, undulate flaps that produce a harmonic lip.
单纯唇裂是唇腭裂谱系中最轻微的形式；然而，这些患者通常采用与更严重病例相同的手术技术进行治疗（推进旋转皮瓣、四边形皮瓣）。对于单纯唇裂或唇段间间隙不宽的情况，米拉唇成形术可能是一种侵入性较小的唇部修复选择。
对2014年5月至2015年12月期间采用米拉唇成形术修复唇裂的所有儿童进行回顾性研究。记录手术时间、出院时间和并发症。从唇高和对称性、鼻形和对称性以及瘢痕外观方面评估美学效果。
在此期间，13例患者接受了米拉唇成形术。平均年龄为6.11个月（5至12个月）。如有鼻不对称，则同时进行一期鼻整形术。唇部修复平均持续85分钟。术后4小时开始经口喂养；按照我们的方案，在其他唇部修复技术后建议术后2周停止奶瓶喂养。在所有13例病例中，除1例唇瘢痕挛缩经曲安奈德注射解决外，结果均为对称、高度合适的上唇和协调的鼻子。无其他术中或术后并发症。
米拉唇成形术可矫正小至中度间隙性唇裂（通常为无牙槽突裂的唇裂）。与其他技术相比，其优点是手术时间较短，皮瓣几何形状较简单、起伏较小，可形成协调的唇部。
