State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road, Chengdu, 610041, China.
Head Face Med. 2019 Jul 17;15(1):20. doi: 10.1186/s13005-019-0203-y.
For a better understanding of common suspension sutures during primary cleft lip nasal rhinoplasty, the biomechanical consequences of those sutures need to be demonstrated.
A finite element model of the infant specimen was established. The closure of cleft lip and four different specific suspension sutures were simulated by loading different forces on the model: 1. F1 to simulate the suture fastening both medial crura together; 2. F2 to simulate the suture which sewed both medial crura and the non-cleft-side upper lateral cartilage together; 3. F3 to simulate the suture elevating the alar cartilage cranially; 4. F4 to simulate the suture elevating the alar cartilage superiorly. The deformation and stress distribution consequent to each maneuver were analyzed in details.
The deviation of columella was restored through the closure of cleft lip. Different suspension sutures had different biomechanical effects on the nasal structure. All suspension sutures had the function on elevating the alar cartilage. F2 had no function on restoring the collapse of the nasal tip. The suture which fastened both medial crura together leaded to the lowest stress on the skin envelope.
Each suspension suture had its characteristics respectively. The simulation suggested that F1, the suture which fastened both medial crura, could be the most potential maneuver for cleft lip rhinoplasty because it can symmetrically restore the shape of the nose without incurring a significant increase in stress.
为了更好地理解初次唇裂鼻整形术中常用的悬吊缝线，需要展示这些缝线的生物力学后果。
建立婴儿标本的有限元模型。通过对模型施加不同的力来模拟闭合唇裂和四种不同的特定悬吊缝线：1. F1 模拟缝线将内眦软骨固定在一起；2. F2 模拟缝线将内眦软骨和非裂隙侧上外侧软骨缝合在一起；3. F3 模拟缝线将鼻翼软骨向上提升；4. F4 模拟缝线将鼻翼软骨向上提升。详细分析了每种操作引起的变形和应力分布。
通过闭合唇裂来恢复鼻中隔的偏斜。不同的悬吊缝线对鼻结构有不同的生物力学影响。所有悬吊缝线都有提升鼻翼软骨的作用。F2 没有修复鼻尖塌陷的作用。将内眦软骨固定在一起的缝线导致皮肤包裹物的应力最低。
每种悬吊缝线都有其特点。模拟表明，F1，即固定内眦软骨的缝线，可能是唇裂鼻整形术最有潜力的操作，因为它可以对称地恢复鼻子的形状，而不会导致明显的应力增加。
