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目的探讨根据口鼻轮廓线设计并完成单侧唇裂Ⅰ期整复的手术方法。方法利用裂隙侧口鼻弯曲轮廓线为手术切口的唇裂手术方式,对196例Ⅰ期单侧唇裂患者进行口唇畸形和鼻部畸形整体设计和矫正,包括:1)手术切口线设计在口鼻弯曲的轮廓线上,和弯曲轮廓线重叠,易于隐蔽;2)充分地剥离及松解组织畸形的异常附着;3)患侧鼻翼软骨和黏膜向内向上,鼻翼软骨内侧脚向外向下旋转,矫正患侧鼻翼软骨;4)唇部肌肉的重叠或褥式缝合重建患侧人中嵴的高度;5)保持人中嵴皮肤的完整性。观察术后的鼻唇效果和对称性。结果患者的患侧上唇形态、唇峰长短、鼻孔大小、鼻小柱形态、鼻翼形态和鼻底塌陷程度,较术前均有明显改善,鼻唇外形接近于正常外形,术后轮廓线上的瘢痕不明显,整复效果满意。结论根据口鼻轮廓线设计单侧唇裂Ⅰ期整复手术方案,能取得良好外形美观效果。
Objective To study the surgical method of designing and completing the unilateral cleft lip Ⅰ reconstruction according to the outline of the nose and nose. Methods A total of 196 patients with unilateral cleft lip Ⅰ were enrolled in the study. One hundred and sixty-six patients with unilateral cleft lip were treated by lip cleft surgery, including: 1) Of the contour line, and the curved contour overlap, easy to conceal; 2) fully stripping and loosening the abnormal attachment of the tissue deformity; 3) the ipsilateral alar cartilage and mucosa inwardly upward, the alar cartilage medial foot outward outward rotation, Ipsilateral alar cartilage; 4) overlapping of lip muscles or mattress suture reconstruction of the height of the affected side of the crest; 5) to maintain the integrity of the human crest skin. Observe the postoperative nasal lip effect and symmetry. Results The shape of the affected upper lip, the length of the lip, the size of the nostril, the shape of the nasal column, the morphology of the nasal wing and the collapse of the nasal floor were significantly improved in the affected side of the patient. The shape of the nasolabial lip was similar to the normal shape, Scar is not obvious, the restoration of satisfactory results. Conclusion According to the outline of the nose and the nose to design a unilateral cleft lip Ⅰ integrative surgical plan, can achieve good aesthetic appearance.