Stelnicki E J, Vanderwall K, Hoffman W Y, Szabo Z, Harrison M R, Foster R, Longaker M T
Division of Plastic and Reconstructive Surgery, Washington University, St. Louis, Missouri, USA.
Cleft Palate Craniofac J. 1998 Sep;35(5):425-9. doi: 10.1597/1545-1569_1998_035_0425_aofero_2.3.co_2.
The purpose of this study was to determine if endoscopic techniques could be used to repair an epithelialized lip cleft with accuracy and with an outcome comparable to fetuses treated through an open hysterotomy.
In contrast to previous open fetal cleft lip repairs in the same model, none of the five fetuses reported here had a good aesthetic result. Although there was no evidence of scar histologically, the edges of the lip were poorly approximated. The epithelial lining and underlying dermis of the wound margins were notably inverted. The orbicularis oris muscle, which had been reapproximated, appeared thin and hypoplastic. Most of the vermilion elements were poorly aligned, and in one animal, there was a complete dehiscence of the repair.
In a more representative model of cleft lip that is not an acute lip wound, in utero endoscopic suture repair of the ovine lip gave a poor result using current technology. Only a meticulously performed, multilayered, open repair of a cleft appears to give a good cosmetic and functional outcome. Further studies to improve the endoscopic repair as our technology advances are therefore warranted.
本研究的目的是确定内镜技术能否用于精确修复上皮化唇裂，其结果是否与通过开放性子宫切开术治疗的胎儿相当。
与同一模型中先前的开放性胎儿唇裂修复不同，此处报道的5例胎儿均未获得良好的美学效果。尽管组织学上没有瘢痕证据，但唇部边缘对合不佳。伤口边缘的上皮衬里和下方的真皮明显内翻。重新对合的口轮匝肌显得薄且发育不全。大多数唇红成分排列不佳，在一只动物中，修复处完全裂开。
在一个更具代表性的非急性唇部伤口的唇裂模型中，使用当前技术进行子宫内内镜缝合修复绵羊唇部的效果不佳。只有精心进行的多层开放性唇裂修复似乎才能带来良好的美容和功能效果。因此，随着技术进步，有必要进一步开展研究以改进内镜修复技术。
