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目的:观察并分析双侧唇裂术后继发过短鼻小柱二期修复中应用上唇叉形瓣延长鼻小柱的临床效果。方法:收集2010年1月~2015年8月收治的双侧唇裂术后继发过短鼻小柱患者10例,男7例,女3例。全麻下行上唇叉形组织瓣结合双侧鼻翼缘“飞燕形”切开的鼻畸形矫正术,应用上唇原切口与鼻小柱基底部之间的上唇组织形成叉形瓣向上方推进,延长鼻小柱;术中同期将双侧鼻翼软骨脱帽分离后重建鼻内软骨支架,延长鼻小柱软骨支架。结果:所有患者术后切口均Ⅰ期愈合;随访0.5~6年,观察鼻小柱延长效果稳定,整体外鼻形态满意。结论:在上唇有多余组织瓣可利用的前提下,应用叉形瓣延长鼻小柱,双侧唇裂术后继发过短鼻小柱的修复可得到稳定满意的效果,值得临床推广应用。
OBJECTIVE: To observe and analyze the clinical effect of upper lip fork-shaped extended columella in the second-stage repair of secondary short cleft lip after bilateral cleft lip surgery. Methods: From January 2010 to August 2015, 10 cases of secondary short cleft lip after cleft lip surgery were collected, including 7 males and 3 females. Under general anesthesia the upper lip fork tissue flap combined with bilateral nasal flange “Cheyenne ” incision rhinoplasty correction, application of the upper lip incision and the base of the nasal column between the upper lip formation of the upper lip to promote the fork , To extend the columella; surgery during the same period of bilateral atrial cartilage off the hatch after reconstruction of nasal cartilage scaffold to extend the columella cartilage scaffold. Results: The incisions of all patients were healed by first intention. After 0.5-6 years of follow-up, the prolongation of the columella was observed and the external nasal morphology was satisfactory. CONCLUSION: Under the premise of the available extra flap on the upper lip, the use of fork-shaped flap to extend the columella and the repair of secondary short cleft lip after bilateral cleft lip may achieve stable and satisfactory results, which is worthy of clinical application.