Nakajima T, Yoshimura Y, Yoneda K, Nakanishi Y
Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan.
Br J Plast Surg. 1998 Oct;51(7):511-6. doi: 10.1054/bjps.1997.0181.
The methods designed for the repair of a complete cleft lip should not be used to repair an incomplete cleft lip. This results too often in the postoperative drooping of the white lip on the affected side because in most incomplete cleft lips there is more tissue on the cleft side than in complete cleft lip. We present and discuss the refinements we made in our original technique for complete cleft lip in order to adapt it to incomplete cleft lip repair. The skin design at the white skin roll follows Cronin's method with an incision perpendicular to the vermilion border. The suture that pulls the edges of the angular incisions together pushes on the white skin roll caudally. This ensures that the peak of the Cupid's bow on the cleft side does not droop postoperatively. It also ensures that it does not take on an acute angle and that the vermilion border will be a continuous line without a break. We do not create a triangular flap at the vermilion border, but we raise a triangular flap at the alar base on the cleft side and advance it to the bottom of the columella. This creates the nostril sill and corrects the flared alar base. The resulting suture line is completely straight and runs along the philtral column. In this way, the postoperative elongation of the white lip on the cleft side can be prevented.
设计用于修复完全性唇裂的方法不应被用于修复不完全性唇裂。这常常导致患侧白唇术后下垂，因为在大多数不完全性唇裂中，裂隙侧的组织比完全性唇裂更多。我们展示并讨论了对最初用于完全性唇裂修复技术所做的改进，以便将其应用于不完全性唇裂修复。白唇皮肤卷处的皮肤设计采用克罗宁法，切口垂直于红唇缘。拉拢口角切口边缘的缝线将白唇皮肤卷向尾侧推移。这确保了裂隙侧丘比特弓的顶点术后不会下垂。它还确保其不会形成锐角，并且红唇缘将是一条连续的线而无中断。我们不在红唇缘处制作三角形皮瓣，而是在裂隙侧鼻翼基部掀起一个三角形皮瓣并将其推进至鼻小柱底部。这形成了鼻槛并矫正了鼻翼基部增宽。最终的缝线完全笔直，沿着人中柱走行。通过这种方式，可以防止裂隙侧白唇术后延长。
