Edington H D, Mooney M P, Losken A, Hurwitz D J, Siegel M I
Division of Plastic and Reconstructive Surgery, School of Medicine, University of Pittsburgh, PA, USA.
Ann Plast Surg. 1998 Aug;41(2):171-9. doi: 10.1097/00000637-199808000-00010.
Midfacial hypoplasia following primary cleft lip repair is a common clinical correlate. Recent experimental work has suggested that increased lip pressure following an undermined lip repair may contribute to midfacial growth inhibition. Soft-tissue expansion has been used to generate additional soft tissue for reconstruction in the cranial region. The use of this technique in the labial region may allow lip repair to be performed with less tension (pressure) and thus facilitate midfacial growth. To test this hypothesis, 40 4-week-old rabbits were randomly divided into four groups. Two groups had surgically created lip and alveolar defects. Ipsilateral labial tissue expanders were placed in all four groups. One cleft and one normal group underwent expansion. The other two groups served as a control. The expanders were removed at 4 weeks, and an undermined lip repair was performed in both cleft groups. Findings revealed that soft-tissue expansion increased labial surface area significantly by approximately 96% (p < 0.001). Labial soft-tissue expansion alone had no effect on midfacial growth during the observation period. In contrast, cleft animals undergoing tissue expansion exhibited significantly reduced (p < 0.05) postoperative lip pressure and increased midfacial growth compared with cleft animals without expansion through 36 weeks of age. Results suggest that preoperative tissue expansion reduced postoperative lip pressure and improved midfacial growth in a rabbit cleft lip model.
一期唇裂修复术后的面中部发育不全是一种常见的临床相关情况。近期的实验研究表明，潜行分离唇修复术后唇压力增加可能会导致面中部生长抑制。软组织扩张已被用于在颅骨区域生成额外的软组织用于重建。在唇部区域使用该技术可能使唇修复在张力（压力）较小的情况下进行，从而促进面中部生长。为了验证这一假设，将40只4周龄的兔子随机分为四组。两组通过手术制造唇和牙槽嵴缺损。所有四组均放置同侧唇部组织扩张器。一组唇裂组和一组正常组进行扩张。另外两组作为对照。4周后取出扩张器，对两组唇裂组进行潜行分离唇修复。结果显示，软组织扩张使唇部表面积显著增加约96%（p < 0.001）。在观察期内，单纯唇部软组织扩张对面中部生长没有影响。相比之下，与未进行扩张的唇裂动物相比，接受组织扩张的唇裂动物在36周龄时术后唇压力显著降低（p < 0.05），面中部生长增加。结果表明，在兔唇裂模型中，术前组织扩张降低了术后唇压力并改善了面中部生长。
