Sharma Sunil, Dhull Kshiteej, Yadav Archana Jai Singh
Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India.
Natl J Maxillofac Surg. 2021 May-Aug;12(2):193-198. doi: 10.4103/njms.NJMS_282_20. Epub 2021 Jul 15.
The purpose of this study is to highlight the role of cartilage correcting suture in single-stage surgical correction for secondary unilateral cleft lip nose deformity with three-dimensional observations of preoperative and postoperative nasal forms.
Between July 2017 and June 2019, 18 consecutive patients of unilateral cleft lip nose deformity aged between 16 and 28 years underwent surgical correction. The corrective procedure of nose involved columellar lengthening, medial and lateral nasal osteotomies along with augmentation of premaxilla by bone graft at premaxilla, and alar base wedge resections. Focus was laid to correct nasal cartilaginous framework using tip sutures along with repositioning of lower lateral cartilages, fixation of the alar cartilage complex to the septum, and the upper lateral cartilages. We investigated the following surgical interventions and nasal tip suture techniques, which were transdomal suture, interdomal suture, lateral crural mattress suture, columella septal suture, and intercrural suture.
We achieved adequate esthetic and functional results in all the patients without any morbidity.
This concept of simultaneous approach toward complete single-stage correction of secondary cleft lip nasal deformity incorporating various cartilage suture using 5-0 nylon in developing nation like ours, where the patient presents late with complex conditions showed promising esthetic and functional outcome.
本研究旨在通过对术前和术后鼻形态的三维观察,突出软骨矫正缝合在二期单侧唇裂鼻畸形一期手术矫正中的作用。
2017年7月至2019年6月,连续18例年龄在16至28岁之间的单侧唇裂鼻畸形患者接受了手术矫正。鼻矫正手术包括鼻小柱延长、鼻内外侧截骨术,同时在上颌前突处通过植骨增加上颌前突,并进行鼻翼基底楔形切除术。重点是使用鼻尖缝线矫正鼻软骨框架,同时重新定位下外侧软骨,将鼻翼软骨复合体固定于鼻中隔及上外侧软骨。我们研究了以下手术干预措施和鼻尖缝合技术,即跨穹窿缝合、穹窿间缝合、外侧脚褥式缝合、鼻小柱鼻中隔缝合和脚间缝合。
所有患者均获得了满意的美学和功能效果,且无任何并发症。
在像我们这样的发展中国家,患者就诊较晚且病情复杂,采用5-0尼龙线同时采用多种软骨缝合进行二期唇裂鼻畸形一期完全矫正的这一理念,显示出了良好的美学和功能效果。