自体肋软骨移植在唇裂二期修复中上唇凹陷修复中的临床应用
[Clinical application of autologous costal cartilage transplantation in repair of upper lip depression in secondary repair of cleft lip].
作者信息
Zhang Xiaoqian, You Xiaobo, Cai Zhen, Liu Quan, Du Liping, Chen Zaihong, Cui Wei, Sheng Yang
机构信息
Graduate School of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China;Department of Plastic Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu Sichuan, 610072, P.R.China.
Department of Plastic Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu Sichuan, 610072, P.R.China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020 Feb 15;34(2):200-205. doi: 10.7507/1002-1892.201906070.
OBJECTIVE
To discuss the clinical application and effectiveness of autologous costal cartilage transplantation in the repair of upper lip depression in the secondary repair of cleft lip.
METHODS
The clinical data of 10 patients of secondary repair of upper lip depression with cleft lip by autologous costal cartilage transplantation between January 2017 and January 2019 were retrospectively analysed. There were 7 males and 3 females with an average age of 24 years (range, 18-33 years). There were 8 cases of bilateral lip fissure and 2 cases of unilateral lip fissure. All of them underwent early lip repair at the age of 2-3 years old. The change of the profile of the soft tissue profile of the upper lip of the patient was quantitatively analyzed before operation and at immediate after operation, including the soft tissue facial angle (G-Sn-Pg'), the nasolabial angle (Cm-Sn-UL), the mentolabial angle (UL-LL-Pg'), the distance between the most salient point of the upper lip to the aesthetic plane (UL-E), the highest point of the frontal part, the projection distance of the most salient point of the upper lip on the plane of the orbital ear (G-UL), and the upper lip protrusion (ULP).
RESULTS
One case had incision infection and healed after dressing change, and in the other 9 patients, the incisions healed by first intention, and no acute infection and other complications occurred. The appearance of the lateral morphology of the upper lip at immediate after operation was significantly improved when compared with that before operation. The value of UL-LL-Pg', UL-E, G-UL, and ULP were significantly increased and G-Sn-Pg' was significantly decreased when compared with preoperative ones ( <0.05). There was no significant difference in Cm-Sn-UL between pre- and post-operation ( =0.821, =0.433). All the 10 patients were followed up 6-24 months, with an average of 15 months. During the follow-up, the soft tissue morphology of the upper lip was good. No long-term complications such as cartilage absorption and cartilage displacement were found.
CONCLUSION
Autologous costal cartilage transplantation is a safe and effective treatment for upper lip depression in the secondary repair of cleft lip.
目的
探讨自体肋软骨移植在唇裂二期修复中对上唇凹陷的临床应用及效果。
方法
回顾性分析2017年1月至2019年1月间10例采用自体肋软骨移植修复唇裂二期上唇凹陷患者的临床资料。男性7例，女性3例，平均年龄24岁（范围18 - 33岁）。双侧唇裂8例，单侧唇裂2例。均在2 - 3岁时接受过早期唇修复术。术前及术后即刻对患者上唇软组织侧貌变化进行定量分析，包括软组织面角（G - Sn - Pg'）、鼻唇角（Cm - Sn - UL）、颏唇沟角（UL - LL - Pg'）、上唇最突点至审美平面的距离（UL - E）、额部最高点、上唇最突点在眶耳平面上的投影距离（G - UL）以及上唇突度（ULP）。
结果
1例切口感染，换药后愈合，其余9例切口一期愈合，未发生急性感染等并发症。术后即刻上唇外侧形态外观较术前明显改善。与术前相比，UL - LL - Pg'、UL - E、G - UL及ULP值显著增加，G - Sn - Pg'值显著降低（<0.05）。术前术后Cm - Sn - UL差异无统计学意义（=0.821，=0.433）。10例患者均随访6 - 24个月，平均15个月。随访期间，上唇软组织形态良好。未发现软骨吸收、软骨移位等远期并发症。
结论
自体肋软骨移植是唇裂二期修复中上唇凹陷的一种安全有效的治疗方法。
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