Rossell-Perry Percy
School of Medicine, Post Graduate Studies, San Martin de Porres University, Peru; and Edgardo Rebagliatti Hospital, Plastic Surgery Service, Lima, Peru.
Plast Reconstr Surg Glob Open. 2020 Jun 24;8(6):e2870. doi: 10.1097/GOX.0000000000002870. eCollection 2020 Jun.
Nasal deformities accompanying unilateral incomplete cleft lip have minor skeletal and soft tissue deficiencies compared with deformities associated with unilateral complete cleft lip. Extended dissection and surgical incisions (often required for nasal deformities in complete cleft lip) are not recommended to address deformities accompanying incomplete cleft lip. The purpose of this study is to describe an innovative method involving a rotational composite flap for nasal repair in patients with unilateral cleft lip.
Since 2016, 49 consecutive patients with unilateral incomplete cleft lip have undergone primary anatomical repair of accompanying nasal deformities. The technique involves a skin incision along the marginal and intercartilaginous borders to create a V-shaped composite flap consisting of vestibular skin and alar cartilage. Rotational mobilization of the composite flap creates a triangular raw surface laterally, which is closed by advancement of the vestibular skin.
This innovative method, which is based on the use of a rotational composite vestibular flap, achieves proper symmetry of the repaired nose.
The herein described composite flap rhinoplasty is a good surgical option, which provides a good overall nasal symmetry in patients with nasal deformities accompanying unilateral incomplete cleft lip.
与单侧完全性唇裂相关的畸形相比，单侧不完全性唇裂伴发的鼻畸形在骨骼和软组织方面的缺陷较小。对于不完全性唇裂伴发的鼻畸形，不建议进行广泛解剖和手术切口（完全性唇裂鼻畸形通常需要）。本研究的目的是描述一种用于单侧唇裂患者鼻修复的创新方法，该方法涉及旋转复合瓣。
自2016年以来，49例连续的单侧不完全性唇裂患者接受了伴发鼻畸形的一期解剖修复。该技术包括沿边缘和软骨间边界做皮肤切口，以形成一个由前庭皮肤和鼻翼软骨组成的V形复合瓣。复合瓣的旋转移动在侧面形成一个三角形创面，通过前庭皮肤推进来封闭。
这种基于旋转复合前庭瓣的创新方法实现了修复后鼻子的适当对称。
本文所述的复合瓣鼻成形术是一种很好的手术选择，可为单侧不完全性唇裂伴发鼻畸形的患者提供良好的整体鼻对称性。
