Oda Yuzuka, Ojima Yosuke, Ayabe Nanako, Aoyagi Maya, Ida Yukiko, Matsumura Hajime
Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
J Plast Reconstr Surg. 2023 Jun 14;3(1):16-20. doi: 10.53045/jprs.2022-0033. eCollection 2024 Jan 27.
Important factors that affect the initial repair of complete bilateral cleft lip (CBCL) include not only the width of the cleft but also the distance between the premaxilla and alveolar bone. We report a case of a patient with CBCL in whom favorable morphological and aesthetical results were achieved by surgical premaxillary setback. The patient was a 5-month-old boy with CBCL, who had a severely protruding premaxilla. Despite repeated lip adhesion before lip closure surgery, wound dehiscence occurred, and therefore, we performed premaxillary setback with vomerine ostectomy. The bone was removed posterior to the vomero-premaxillary suture, and the premaxilla was indirectly stabilized by bilateral mucosal bridging. The procedure for the vomer worked well, and his premaxilla was moved back enough to undergo surgery. The premaxillary setback is thought to be a reasonable option to treat CBCL in patients with a protruding premaxilla. The subsequent long-term follow-up of the midfacial development of these patients is necessary.
影响双侧完全性唇裂（CBCL）初期修复的重要因素不仅包括唇裂宽度，还包括前颌骨与牙槽骨之间的距离。我们报告一例双侧完全性唇裂患者，通过手术将前颌骨后推，获得了良好的形态和美学效果。该患者为一名5个月大的双侧完全性唇裂男婴，前颌骨严重前突。尽管在唇裂闭合手术前反复进行唇粘连，但仍发生伤口裂开，因此，我们进行了犁骨切除术并将前颌骨后推。在犁骨-前颌骨缝线后方去除骨质，通过双侧黏膜桥间接稳定前颌骨。犁骨手术操作顺利，其前颌骨后移足够距离以进行手术。前颌骨后推被认为是治疗前颌骨前突的双侧完全性唇裂患者的合理选择。对这些患者的面中部发育进行后续长期随访是必要的。
