Williams J K, Hitner J B, Wood R J
Joseph B. Whitehead Department of Surgery, Emory University Hospital, Atlanta, Ga., USA.
Plast Reconstr Surg. 1997 Jan;99(1):230-3. doi: 10.1097/00006534-199701000-00035.
This case describes a repair of a unilateral cleft lip complicated by a lip hemangioma. The relevant issues regarding timing of the repair include safety of the procedure by minimizing blood loss during excision of the hemangioma and minimizing anesthesia risk. In obtaining a lasting cosmetic result, excision of the hemangioma would need to be done when the potential for residual tumor growth would be least likely (during tumor involution). Finally, the difficult issue of psychosocial concerns would balance the need for traditional early cleft repair with a definitive repair prior to increased social interaction in school. All these concerns were met with a delayed single-stage repair after partial involution of the hemangioma. We feel that a single-stage excision and lip repair is an acceptable option. It is reasonable to delay the cleft lip repair until significant involution of the hemangioma has occurred. An acceptable aesthetic result is obtainable.
本病例描述了一例单侧唇裂修复术,该唇裂合并唇部血管瘤。修复时机的相关问题包括手术的安全性,即尽量减少血管瘤切除过程中的失血以及降低麻醉风险。为获得持久的美容效果,需要在血管瘤残留生长可能性最小的时候(即肿瘤消退期)切除血管瘤。最后,心理社会问题这一难题需要在传统的早期唇裂修复需求与在孩子入学社交增加之前进行确定性修复之间进行权衡。在血管瘤部分消退后进行延迟一期修复解决了所有这些问题。我们认为一期切除及唇修复是一个可接受的选择。将唇裂修复推迟到血管瘤显著消退后是合理的。可以获得可接受的美学效果。