旋转推进法单侧唇裂修复术中鼻底切口设计与缝合的改进.pdfVIP

32 中国美容医学2015年3月第24卷第5期 ChineseJournalofAestheticMedicine.Mar.2015.Vol.24.No.5 ·颌面美容· ·论著· 旋转推进法单侧唇裂修复术中鼻底切口设计与缝合的改进 刘 丰，杨汉林 (湖南省人民医院口腔颌面外科 湖南 长沙 410005) [摘要]目的：介绍一种改进瓣尖设计与缝合位点的术式。方法：患侧推进瓣瓣尖设计成弧形，缝合时弧形顶 点第7点与健侧鼻小柱下第5点缝合，第6点与6点缝合。结果：整个上唇唇弓自然，唇高双侧对称，鼻小柱 下方瘢痕明显减少，患者家属满意度高。结论：微调整Millard切口设计及缝合方式，可获得良好的唇裂修 复效果，提高单侧唇裂患者家属的满意度。 [关键词]唇裂；旋转推进法；患者满意度 [中图分类号]R782 [文献标志码]A [文章编号]1008-6455（2015）05-0032-03 AnewmodifiedMillardmethodofunilateralcleftliprepairbyimprovementof nasalfloorincisionandsuturepointdesign LIUFeng,YANGHan-lin (DepartmentofOralandMaxillofacialSurgery,HunanProvincialPeoplesHospital,Changsha410005, Hunan,China) Abstract: Objective Millards rotation advancement technique has long been considered as principal of unilateral cleft lip repair.However,this method owe a constant postoperative effect,we introduce a modified technique to better design the C flap and the suture point. Methods We presentaretrospectivereviewof 25 casesofunilateralcleftlippatients,averageage 5.2 months, referredtothedepartmentoforalandmaxillofacialsurgeryofHunanprovincialpeopleshospitalfrom MarchtoDecemberof 2012.Aback-cutwasdesignedtoendatthelip-columellarjunctionandthe C-flapisusedtobothfillthecolumellardefectandabuttherotatedlipsegment,andoutlineofthe peakofCflapwasarcratherthanangular.Theskinpoint 7 suturedwithpoint 5,point6 suturedwith point 6. Results TheCupidsbowandthelipheightweresymmetry,thescarbelowthecolumella decreased significantly，the patient family satisfaction was high. Conclusion These results suggestedthatmodifiedtheCflapandsuturepointcanbeachievedusingourtechnique. Keywords:cleftlip;Millardmethod;patientsatisfaction 在单侧唇裂修复术中，特别是中完全性唇裂 1 资料和方法 中，组织量明显不足，Millard 法为基础的旋转推 1.1 一般资料 进法目前应用十