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如果不再纠结于肌肉大体解剖本身,而是将视线转向肌肉纤维层面,研究唇鼻肌肉纤维力线与唇鼻形态的生物力学关系,则可能产生对功能性唇裂修复技术不同的思路.近十年来,笔者围绕唇鼻部肌肉纤维的解剖、影像学和生物力学领域开展了一系列研究工作,实现了唇鼻部细小肌肉纤维层面的三维可视化,建立了健康人和唇裂患者唇鼻部肌肉纤维的组态模型,并提出唇鼻肌肉张力线假说;根据唇鼻部肌肉、软骨、皮肤和皮下组织的生物力学参数,初步建立了唇鼻肌肉张力线与体表形态关系的生物力学模型;归纳出3组决定唇鼻轮廓的肌肉张力线组,从生物力学角度解释了先天性唇裂和各种唇鼻畸形的生物力学机制,同时在理论上实现了通过唇鼻肌肉张力线组重建技术自由改变唇鼻三维轮廓的可能性,初步建立了该理论的外科技术体系;通过在唇裂临床治疗中的临床验证,最终建立“唇鼻肌肉生物力学仿真”的技术体系.将肌肉解剖性复位转变为肌肉生物力学仿真,是功能性唇裂修复的另一个方向,是从理论上对传统技术进行变革的初步尝试.“,”We are no longer entangled in the anatomical resetting of the labial-nasal muscle itself,but the sight to the muscle fiber level,to study the relationship between the muscle fiber force line and the labial-nasal shape.In the past ten years,we focused on the lip of nasal muscle fiber anatomy,imageology and biomechanics,carried out a series of research works,realized the three-dimensional (3D) visualization of small labial-nasal muscle fiber,established configuration models of normal and cleft lip with nasal muscle fibers,and put forward the hypothesis of naso-labial muscle tension band.According to the biomechanical parameters of lip nasal muscle,cartilage,skin and subcutaneous tissue,we initially established a biomechanical model elaborating the relationship between labial-nasal muscle tension lines and surface morphology;we summed up three muscle tension group which determines labial-nasal contour,explained the biomechanical mechanism in cleft lip and various lip nasal deformities,and realized the possibility to freely change the 3D labial-nasal contour by lip nasal lip nasal muscle tension theory;Finally we carried out clinical validation in clinical treatment of cleft lip,achieved the effect of detail cleft lip repairing.