Affiliated Hospital of Zunyi Medical College, Huichuan District.
Oral Maxillofacial Trauma and Orthognathic Surgery. Hospital of Stomatology, Zunyi Medical University, Zunyi, China.
J Craniofac Surg. 2021 May 1;32(3):1094-1098. doi: 10.1097/SCS.0000000000007536.
After many years in clinical practice, the authors found that the long-term aesthetics of the upper lip and nose following repair of a unilateral cleft lip deformity using the Huaxi method remained unsatisfactory. The immediate postoperative effect was often good, while the long-term postoperative effect was poor. Therefore, this study aimed to evaluate the characteristics and influencing factors of a modified Huaxi method for repairing unilateral cleft lip over time, and to explore the relationship between immediate and long-term outcomes after cleft lip surgery.
Patients with unilateral cleft lip who visited the Department of Maxillofacial Surgery of the Stomatological Hospital of Zunyi Medical University from June 2014 to March 2016 were selected. The study group consisted of 51 consecutive patients (30 boys and 21 girls), aged between 3 months and 2 years. Of these, 24 presented with complete unilateral cleft lip (12 wore a nasoalveolar mold as required, 12 did not) and 27 with incomplete unilateral cleft lip (13 wore a nasoalveolar mold as required, 14 did not). Photographs were taken of 51 patients before surgery and immediately, 7 days, and 6 months postoperatively. Various indexes of nasolabial contour of each patient were measured using iWitness photogrammetry, and the slit width; lip height ratio, lip width ratio, nostril width ratio, and nostril height ratio of the healthy side; and degree of deviation of the nasal columella were calculated.
Long-term symmetry of lip height and width remained stable postoperatively (P > 0.05), whereas nostril height symmetry was significantly reduced (P > 0.05). Nasal width symmetry and midpoint deviation of the nasal columella were stable in patients with nasoalveolar molding (P > 0.05), but significantly decreased in patients without nasoalveolar molding (P < 0.05). In patients with complete unilateral cleft lip, there was a significant correlation between fissure width and lip width symmetry 6 months postoperatively (r = 0.431, P < 0.05).
The symmetry of the upper lip is satisfactory and stable following surgical repair with the modified Huaxi technique. However, undercorrection of nasal symmetry is commonplace. Fissure width and nasoalveolar molding may influence long-term aesthetics following unilateral cleft lip repair.
华西法修复单侧唇裂多年的临床实践中，作者发现上唇和鼻的长期美学效果并不令人满意。术后即刻效果往往良好，而长期术后效果较差。因此，本研究旨在评估改良华西法修复单侧唇裂的特点和影响因素，探讨唇裂术后即刻和长期效果的关系。
选择遵义医科大学口腔医院颌面外科 2014 年 6 月至 2016 年 3 月就诊的单侧唇裂患者。研究组为 51 例连续患者（男 30 例，女 21 例），年龄 3 个月至 2 岁。其中完全单侧唇裂 24 例（12 例按要求佩戴鼻牙槽塑形器，12 例未佩戴），不完全单侧唇裂 27 例（13 例按要求佩戴鼻牙槽塑形器，14 例未佩戴）。术前、术后即刻、术后 7 天和 6 个月对 51 例患者拍摄照片。采用 iWitness 摄影测量法测量每位患者的鼻唇轮廓各项指标，计算健侧裂宽、唇高比、唇宽比、鼻孔宽比、鼻孔高比、鼻中隔偏曲程度。
唇高和唇宽的长期对称性术后保持稳定（P>0.05），而鼻孔高度的对称性明显降低（P>0.05）。佩戴鼻牙槽塑形器的患者，鼻宽对称性和鼻中隔中点偏曲稳定（P>0.05），未佩戴鼻牙槽塑形器的患者明显降低（P<0.05）。完全单侧唇裂患者术后 6 个月裂宽与唇宽对称性呈显著相关（r=0.431，P<0.05）。
改良华西法修复后，上唇对称性满意且稳定。然而，鼻对称性矫正不足较为常见。裂隙宽度和鼻牙槽塑形可能影响单侧唇裂修复后的长期美学效果。
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