Salomonson J
Saint John's Cleft Palate Center, Santa Monica, California, USA.
Scand J Plast Reconstr Surg Hand Surg. 1996 Jun;30(2):111-20. doi: 10.3109/02844319609056392.
Techniques for cleft lip reconstruction continue to evolve as plastic surgeons strive to achieve the most natural lip and nasal configuration. Critical analysis of cleft lip repairs led to the development of the ipsilateral columellar Z-plasty. Since 1988, 120 infants have undergone this procedure as their primary cleft lip repair. The philtrum is designed as a symmetric aesthetic unit extending into the columella as needed. The entire tissue deficiency is then reflected in the columella. The defect is filled by an ipsilateral flap which is designed as an asymmetric Z-plasty with the resultant transverse limb at the junction of the lip and columella. The abnormally oriented muscle is extensively dissected and reconstructed as a separate layer. The nasal deformity is reconstructed by elevating and rotating the displaced alar cartilage and controlling the dead space with bolsters or nasal conformers. This method suggests a way of rearranging the medial segment tissue to achieve adequate columellar length and a symmetric philtrum, with the cutaneous scar, the mirror image of the philtral column on the non-cleft side. The lateral tissue remains lateral with less mucosal attenuation and tightening.
随着整形外科医生努力实现最自然的唇部和鼻部形态，唇裂修复技术不断发展。对唇裂修复的批判性分析促使同侧鼻小柱Z成形术的发展。自1988年以来，120名婴儿接受了该手术作为其初次唇裂修复。人中被设计为一个对称的美学单元，根据需要延伸至鼻小柱。然后将整个组织缺损反映在鼻小柱上。缺损由同侧皮瓣填充，该皮瓣被设计为不对称Z成形术，其最终的横向肢体位于唇部与鼻小柱的交界处。对方向异常的肌肉进行广泛解剖，并作为一个单独的层次进行重建。通过抬高和旋转移位的鼻翼软骨并用支撑物或鼻整形器控制死腔来重建鼻畸形。该方法提出了一种重新排列内侧段组织的方法，以实现足够的鼻小柱长度和对称的人中，皮肤瘢痕为非裂侧人中柱的镜像。外侧组织保持在外侧，黏膜变薄和收紧程度较小。
