Department of Plastic & Reconstructive Surgery, The Ninth Affiliated Hospital of Shanghai Jiaotong Medicine University, 639 Zhi Zao Ju Rd. Shanghai, 200011, PR China.
Department of Breast Surgery, LiaoNing Cancer Hospital & Institute, PR China.
J Craniomaxillofac Surg. 2020 Jun;48(6):569-573. doi: 10.1016/j.jcms.2020.03.008. Epub 2020 Apr 7.
In the treatment of philtral ridge deficiency in cleft lip patients, optimal results are difficult to obtain due to visible scarring following surgery. The purpose of this article is to introduce a novel strategy for philtrum reconstruction along with an evaluation of postoperative outcomes of this technique.
All patients with a deficiency of the philtrum underwent reconstruction of the philtral ridge and upper lip using an orbicularis oris muscle flap with a specific re-suturing technique in our study. The convexity of the philtral ridge was evaluated pre- and postoperatively at rest and while puckering using patient photography as well as three-dimensional simulation technology. Postoperative outcomes and complications were assessed during follow-up, including a patient satisfaction survey.
Thirty cleft lip patients underwent treatment in this study using a specific orbicularis oris muscle re-suturing technique. The average age of the 13 male and 17 female patients was 31.5 years. The follow-up period ranged from 6 months to 3.5 years with an average of 10.3 months. Postoperative results showed an aesthetic reconstructed philtral ridge with stable outcome. Complications included acute infection (1 case) and temporary stiffness of smile (3 cases). No systemic complications occurred. All patients were satisfied with their results, and none required further surgery.
We propose a simple, effective, and reproducible technique involving an orbicularis oris muscle flap for the creation of the philtral column in secondary cleft lip deformity. Our approach allowed aesthetically pleasing and stable outcomes. Although the short-term results of the philtrum reconstruction seem to be adequate there is no information on the long-term situation, and therefore no general recommendation to adopt this method can be given.
在唇裂患者的鼻唇沟缺陷治疗中，由于手术后会留下明显的疤痕，因此很难获得理想的效果。本文旨在介绍一种新的鼻唇沟重建策略，并评估该技术的术后效果。
本研究中所有鼻唇沟缺陷的患者均采用口轮匝肌肌瓣，并采用特定的重新缝合技术进行鼻唇沟和上唇重建。术前和术后使用患者照片以及三维模拟技术评估鼻唇沟的凸度，评估在休息和撅嘴时的凸度。在随访期间评估术后结果和并发症，包括患者满意度调查。
本研究中 30 例唇裂患者采用特定的口轮匝肌重新缝合技术进行治疗。13 名男性和 17 名女性患者的平均年龄为 31.5 岁。随访时间为 6 个月至 3.5 年，平均为 10.3 个月。术后结果显示，重建的鼻唇沟具有美观的外形，效果稳定。并发症包括急性感染（1 例）和微笑暂时性僵硬（3 例）。无全身并发症发生。所有患者对治疗结果均满意，无需进一步手术。
我们提出了一种简单、有效且可重复的技术，涉及使用口轮匝肌肌瓣来创建继发唇裂畸形的鼻唇柱。我们的方法可以达到美观且稳定的效果。虽然鼻唇沟重建的短期效果似乎足够，但长期情况尚不清楚，因此不能普遍推荐采用这种方法。
