先天性唇、面裂和腭裂ppt课件.ppt

* The lip scar is very wide and obvious, which influenced the appearance seriously, so that needed second operation. * If the deformities is very complicated, the duration of operation is longer, the patient didn’t cooperate, we adopt general anesthesia; If the deformities is simple, the duration of operation is not long, the patient have good cooperation, we adopt local anesthesia; * Before doing the operation, we should do some work to make operation safe and success. We should test blood, examine xray of chest and prevent rash and inflammation in facial area. * Next I will simply introduce three operation methods to you. These methods are popular in repair of secondary nasolabial deformities. The follow is reference for you 手术年龄 混合牙列期（9－11岁） 尖牙牙根形成1/2到2/3长度 最小程度影响上颌骨的生长发育，最大程度达到手术目的 术前准备 牙片、咬合片 全景片 CT 牙片 了解裂隙邻牙及牙胚的位置，裂隙的宽度，估计取骨量，植骨区乳牙和恒牙的去留。 全景片 了解整体牙齿的发育情况，患侧尖牙的位置，牙根发育阶段及邻牙相互关系。 CT 骨源 自体骨：髂骨、颅骨、胫骨松质骨、肋骨、下颌骨正中联合及磨牙后区 生物材料：羟基磷灰石(HA)、三磷酸钙(TCP) 组织工程化骨 切口设计 裂隙或瘘口小，软组织基本无缺损：松弛后直接拉拢缝合。 裂隙较宽：设计基底在侧上方的龈唇粘膜瓣，组织瓣滑行或旋转到裂隙区，覆盖在移植骨表面缝合。 裂隙宽、口鼻瘘大，软组织缺损多者：在颊沟设计蒂在上方的唇颊粘膜组织瓣，旋转覆盖在移植骨表面，甚至可跨过牙槽嵴顶到腭侧。 手术 口内切口 髂部切口 形成植骨床 手术要点 切口设计要考虑到关闭创口时要有足够的软组织覆盖。 关闭口鼻腔侧裂隙要无张力，且严密缝合。 裂隙中的疤痕结缔组织要去除，使植骨床彻底被植入骨充填。 松质骨要妥善保存，颗粒均匀，充填完全 术后处理 局部加压 保持口腔卫生，给予抗生素3～5天 减少局部运动，术后软食1～2周 10～14天拆线 术后六月 术前 正畸治疗 义齿修复 唇腭裂的治疗 需要多学科专业人士合作完成 仅靠单学科，单一人员是不可能获得理想的疗效 * Let’s begin. At last class, professor yang told us a little of knowledge about cleft lip, such as embryology, etiology, clinical classification and operation…... Today, we will go on these course. The contents of the lesson include two parts: secondary nasolabial deformities and cleft palate. * Now, the part one has begun. What is secondary nasolabial deformities? There are two photos: the left is normal and the right is the patient who was after repair of CL. We can see the patient’s nose and lip was abnormal. So we named nasolabial deformities after cheiloplasty secondary nasolabial deformities. * We should correction these defor