Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, (Head: Apl. Prof. Dr Dr A.W. Eckert), Ernst-Grube-Straße 40, 06120 Halle, Germany.
Department of Oral and Maxillofacial and Facial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, (Head: Apl. Prof. Dr Dr A.W. Eckert), Ernst-Grube-Straße 40, 06120 Halle, Germany.
J Craniomaxillofac Surg. 2019 Oct;47(10):1557-1562. doi: 10.1016/j.jcms.2019.07.010. Epub 2019 Jul 19.
This study describes a modified method for secondary correction of whistling deformities in patients with unilateral and bilateral cleft lip/palate (CL/P), using a horizontal double transposition vermilion flap, including parts of the orbicularis oris muscle. The pre- and postoperative results were objectively evaluated.
34 patients with a whistling deformity who underwent secondary reconstruction between 07/2013 and 11/2018 were included in this study (mean age 20.2 ± 11.6 years). 24 patients were male and 10 female. 30 patients presented with cleft lip and palate (CLP) - 15 bilateral, nine on the left side and six on the right. Four patients had only a left-side cleft lip (CL). The whistling deformity reconstruction was carried out using two triangular transposition vermilion flaps with muscle parts, for a vertical Z-plasty. The surgical procedure is normally performed under local anesthesia in all patients older than 10 years. For statistical evaluation, the size of the whistling defect in the vermilion was determined on photographs before and 6-9 months after surgery. The individual defect score (DS) was evaluated pre- and postoperatively. In all patients, no additional surgical procedures, such as rhinoplasty or scar correction in the upper lip, were carried out simultaneously.
Minor (DS < 400), moderate (DS 400-1400), and severe (DS > 1400) whistling defects were surgically corrected. The whistling defect score was significantly reduced in all patient groups (p < 0.001). In six patients the result of surgery was rated as 'acceptable' (DS > 30), in five patients as 'good' (DS 10-30), and in 23 patients as 'very good' (DS 0-10).
This study describes a modified method for whistling deformity reconstruction in uni- and bilateral clefts. The aesthetic results are based on a reconstruction of the subcutaneous muscle layers and the creation of a symmetrical lip contour and prolabium using transposition flaps from the lateral side of the cleft. The great advantage is the uncomplicated performance under local anesthesia, even for all children over 10 years, and the short operation time. Postoperative complications did not occur.
本研究描述了一种改良的方法，用于单侧和双侧唇裂/腭裂（CL/P）患者的口哨畸形的二次矫正，使用水平双交叉唇红瓣，包括部分口轮匝肌。对术前和术后结果进行了客观评估。
本研究纳入了 2013 年 7 月至 2018 年 11 月期间接受二次重建的 34 例口哨畸形患者（平均年龄 20.2±11.6 岁）。24 例为男性，10 例为女性。30 例患者存在唇裂和腭裂（CLP）-15 例双侧，9 例左侧，6 例右侧。4 例患者仅存在左侧唇裂（CL）。口哨畸形重建采用两个带有肌肉部分的三角形交叉唇红瓣，行垂直 Z 成形术。对于所有年龄大于 10 岁的患者，手术通常在局部麻醉下进行。为了进行统计学评估，在手术前和手术后 6-9 个月，通过照片确定唇红上口哨畸形的大小。在术前和术后评估个体缺陷评分（DS）。在所有患者中，没有同时进行其他手术，如鼻整形术或上唇瘢痕矫正。
对轻微（DS<400）、中度（DS 400-1400）和严重（DS>1400）口哨畸形进行了手术矫正。所有患者组的口哨缺陷评分均显著降低（p<0.001）。6 例患者的手术结果评为“可接受”（DS>30），5 例患者评为“良好”（DS 10-30），23 例患者评为“非常好”（DS 0-10）。
本研究描述了一种改良的单侧和双侧裂口哨畸形重建方法。美学效果基于重建皮下肌肉层，并使用来自裂侧的转移瓣创建对称的唇轮廓和前唇。其优点是即使对于所有 10 岁以上的儿童，在局部麻醉下也能简单地进行手术，且手术时间短。术后无并发症发生。
