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在单侧不完全性唇裂修复中采用五瓣法及短直线切口进行肌肉重建。

Muscle reconstruction using a five-flap method with a short straight-line incision in unilateral incomplete cleft lip repair.

作者信息

Diao J-S, He L, Yu X-Y, Liu X-Y, Rahman Md A, Shu M-G

机构信息

Department of Plastic, Aesthetic and Maxillofacial Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Republic of China.

Department of Plastic Surgery, East West Medical College and Hospital, Turag, Dhaka, Bangladesh.

出版信息

Int J Oral Maxillofac Surg. 2024 Dec;53(12):997-1005. doi: 10.1016/j.ijom.2024.07.017. Epub 2024 Aug 1.

Abstract

When performing a unilateral incomplete cleft lip repair, it is essential to create a good sub-structure of the upper lip contour, reconstruct the orbicularis oris muscle, and prevent an unwanted scar. The aim of this study was to investigate the clinical effect of muscle reconstruction using a five-flap method with a short straight-line incision in unilateral incomplete cleft lip repair. Thirty-two infants with unilateral incomplete cleft lip were treated with this method between April 2020 and February 2023. A short straight-line incision was designed along the philtral column. The orbicularis oris muscle was reconstructed with a five-flap method in three areas: nasal base area, white lip area, and red lip area. Patient outcomes were assessed through subjective evaluation and anthropometric measurements. No patient experienced any postoperative complications. The philtral column and Cupid's bow were well reconstructed. Deviation of nasal columella was corrected and the nasal floor was elevated. Functionally and aesthetically satisfactory outcomes were obtained in all patients over long-term follow-up. In conclusion, this technique was able to create a good sub-structure of the nasolabial contour and bring a significant improvement in bilateral symmetry, showing it to be an effective method for incomplete unilateral cleft lip repair with minimal scarring.

摘要

在进行单侧不完全性唇裂修复时,创建良好的上唇轮廓亚结构、重建口轮匝肌并防止出现不理想的瘢痕至关重要。本研究的目的是探讨在单侧不完全性唇裂修复中采用短直线切口五瓣法进行肌肉重建的临床效果。2020年4月至2023年2月期间,对32例单侧不完全性唇裂婴儿采用该方法进行治疗。沿人中嵴设计一条短直线切口。采用五瓣法在鼻基底区、白唇区和红唇区三个区域对口轮匝肌进行重建。通过主观评估和人体测量评估患者的治疗效果。无患者出现任何术后并发症。人中嵴和唇弓重建良好。鼻小柱偏斜得到矫正,鼻底抬高。通过长期随访,所有患者在功能和美学方面均获得了满意的效果。总之,该技术能够创建良好的鼻唇轮廓亚结构,并显著改善双侧对称性,显示出它是一种用于单侧不完全性唇裂修复且瘢痕最小的有效方法。

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