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使用双侧唇红肌黏膜滑行瓣修复双侧唇裂术后唇结节缺损:病例系列

Correction of labial tubercle defect in repaired bilateral cleft lips using bilateral vermilion musculomucosal sliding flaps: Case series.

作者信息

Liang Yun, Yang Yusheng, Wu Yilai

机构信息

Department of Oral and Craniomaxillofacial Surgery, The Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai Institute of Stomatology, National Center for Clinical Research of Oral Diseases, Shanghai, China.

出版信息

Medicine (Baltimore). 2019 Jul;98(29):e16161. doi: 10.1097/MD.0000000000016161.

DOI:10.1097/MD.0000000000016161
PMID:31335670
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6709140/
Abstract

RATIONALE

Insignifificant, asymmetrical or lack of labial tubercle often occurs after cleft lip surgery due to improper treatment of vermilion tissue. Especially in the cases of bilateral cleft lip, because of short front lip and insuffificient vermilion tissue, the median vermilion depression often occurs after surgery, forming a "whistling" deformity. The object of this study is to verify the outcomes of patients with median labial tubercle detects after treatment with bilateral vermilion musculomucosal sliding flflaps (VMSF).

PATIENT CONCERNS

Six patients with median labial tubercle defect after bilateral cleft lip repair from March 2015 to May 2017 were enrolled in our department and subjected to bilateral lip deformity correction under general anesthesia.

DIAGNOSES

Secondary deformity of bilateral cleft lip forming a "whistling" deformity were diagnosed in all the patients.

INTERVENTIONS

Bilateral VMSF were designed and used to reconstruct the median labial tubercles by sliding downward so as to eliminate the whistling deformity.

OUTCOMES

During the 10 to 37 months of follow-up, the reconstructed vermilion tubercles had stable morphology showing no whistling deformity and the overall lip shapes were satisfactory.

LESSONS

Reconstructing MVTD and eliminating whistling deformity using the scar tissues that need to be removed previously on the vermilion musculomucosa has achieved stable and satisfactory results and is worthy of clinical application.

摘要

理论依据

唇裂手术后,由于唇红组织处理不当,常出现唇结节不明显、不对称或缺失的情况。特别是双侧唇裂病例,由于前唇短且唇红组织不足,术后常出现正中唇红凹陷,形成“口哨”畸形。本研究的目的是验证双侧唇红肌黏膜滑行瓣(VMSF)治疗后正中唇结节检测患者的疗效。

患者情况

2015年3月至2017年5月,我科收治了6例双侧唇裂修复术后正中唇结节缺损的患者,在全身麻醉下进行双侧唇畸形矫正。

诊断

所有患者均诊断为双侧唇裂继发畸形,形成“口哨”畸形。

干预措施

设计双侧VMSF,通过向下滑行重建正中唇结节,以消除口哨畸形。

结果

在10至37个月的随访中,重建的唇红结节形态稳定,无口哨畸形,整体唇形满意。

经验教训

利用唇红肌黏膜上原本需要切除的瘢痕组织重建正中唇结节缺损并消除口哨畸形,取得了稳定且满意的效果,值得临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/6709140/4840714992e8/medi-98-e16161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/6709140/8702694573b8/medi-98-e16161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/6709140/8f91187dff00/medi-98-e16161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/6709140/4840714992e8/medi-98-e16161-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/6709140/8702694573b8/medi-98-e16161-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/6709140/8f91187dff00/medi-98-e16161-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb1d/6709140/4840714992e8/medi-98-e16161-g003.jpg

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本文引用的文献

1
Bilateral cleft lip and whistling deformity: the X flap procedure for its correction.双侧唇裂与口哨样畸形:用于矫正的X瓣手术
Plast Reconstr Surg. 2006 May;117(6):1986-91. doi: 10.1097/01.prs.0000218328.24577.81.
2
[Classification and repairing investigation of the whistling deformities in the patients with bilateral cleft lip or bilateral cleft lip and cleft palate after primary cleft lip repair].[双侧唇裂或双侧唇腭裂患者一期唇裂修复术后口哨样畸形的分类及修复研究]
Zhonghua Zheng Xing Wai Ke Za Zhi. 2005 Jul;21(4):261-3.