Zide B M, Glat P M, Stile F L, Longaker M T
Institute of Reconstructive Plastic Surgery, New York University Medical Center, N.Y., USA.
Plast Reconstr Surg. 1997 Dec;100(7):1674-81. doi: 10.1097/00006534-199712000-00005.
Port-wine (capillary) vascular malformations that enlarge the lips (port-wine macrocheilia) are challenging reconstructive problems which, as a result, often go untreated. The surgical management of these lesions is not straightforward. Scarification by laser to diminish the discoloration has been performed with good results in some cases. However, laser treatment does little to correct three-dimensional tissue deformities such as macrocheilia, which must be addressed surgically. We present our experience with the treatment of port-wine macrocheilia in 11 patients over the 10-year period between 1983 and 1994. Basic principles for surgical and nonsurgical treatment of these patients are also discussed. Normative data about lip dimensions are important to surgical planning. We used 40 male and female volunteers, all less than 30 years of age, as a source for measuring normal lip dimensions, thereby creating a normative database. Preestablished points in the labial and perioral region were marked. Measurements were taken and then averaged. This information was used as a guide for surgical excision of large defects in some patients. In addition, in both the lower and the upper lip, if the opposite side is uninvolved, this database could serve as a template for reconstruction of the affected side. Between 1983 and 1994, 11 patients underwent surgery for port-wine macrocheilia. Of the 11 patients, 1 had previous treatment consisting of laser scarification. Four patients had port-wine vascular malformations involving the upper lip alone, four involved the lower lip alone, and three involved both lips. In six patients, other areas of the face and body were also involved. Our experience has led us to perform earlier surgical intervention than has previously been described for these patients. Basic reconstructive surgical principles and planning based on normative data and templates can lead to excellent results.
使唇部增大的葡萄酒色（毛细血管）血管畸形（葡萄酒色巨唇）是具有挑战性的重建难题，因此常常得不到治疗。这些病变的外科处理并不简单直接。在某些病例中，通过激光划痕以减轻色素沉着取得了良好效果。然而，激光治疗对于纠正诸如巨唇等三维组织畸形作用甚微，而这些畸形必须通过手术来解决。我们介绍了1983年至1994年这10年间对11例葡萄酒色巨唇患者的治疗经验。还讨论了这些患者手术和非手术治疗的基本原则。唇部尺寸的规范数据对手术规划很重要。我们以40名年龄均小于30岁的男性和女性志愿者作为测量正常唇部尺寸的来源，从而创建了一个规范数据库。在唇部和口周区域标记预先确定的点。进行测量然后取平均值。这些信息被用作一些患者大缺损手术切除的指导。此外，在下唇和上唇，如果对侧未受累，该数据库可作为患侧重建的模板。1983年至1994年期间，11例患者接受了葡萄酒色巨唇手术。11例患者中，1例曾接受过激光划痕治疗。4例患者的葡萄酒色血管畸形仅累及上唇，4例仅累及下唇，3例累及上下唇。6例患者面部和身体的其他部位也受累。我们的经验使我们对这些患者进行了比以往报道更早的手术干预。基于规范数据和模板的基本重建手术原则和规划可带来极佳效果。
