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目的:为婴儿单侧唇裂功能性修复提供解剖学基础。方法:４例正常成人新鲜头颈标本,在下颌下缘面动脉远心端内注入红色乳胶。５例正常婴儿、６例单侧唇(腭)裂婴儿标本,经福尔马林固定,从皮肤面和粘膜面解剖上唇口轮匝肌,在手术显微镜下观察口轮匝肌的形态及血管的分布。结果:口轮匝肌分深浅二层。深层肌肉呈水平方向,起自一侧口角的皮肤和粘膜,走向另一侧口角。浅层由上下两束肌纤维组成。单侧完全性唇裂标本显示患侧深层肌肉在裂隙处中断,止于红唇由厚转薄处。而浅层肌肉不仅中断,其附丽点亦发生错位,造成鼻小柱、鼻翼畸形。健侧深层肌肉在裂隙处中断,浅层肌纤维均附于鼻小柱基部,造成鼻小柱向健侧偏斜。正常上唇动脉起始部和走行都较恒定,本组未见解剖异常。唇裂标本显示,一侧动脉不能与对侧同名动脉吻合成弓,还造成异常走行。结论:对单侧完全性唇裂功能性修复,患侧皮下剥离要达到鼻翼外侧,把扭曲错位的浅层肌组织从鼻翼基部及鼻翼外侧的骨膜上进行分离,并按解剖形态进行复位。
Objective: To provide an anatomical basis for functional unilateral cleft lip repair in infants. Methods: Four fresh adult neck and neck specimens were injected with red latex into the distal end of the mandibular lower edge facial artery. 5 normal infants and 6 unilateral labial (cleft palate) infants were fixed by formalin. The upper lip orbicularis muscle was dissected from the skin surface and mucosa. The morphology of the orbicularis oris muscle and blood vessels were observed under a surgical microscope Distribution. Results: Orbicularis muscle points deep two. Deep muscle was horizontal, starting from the side of the mouth and skin mucosa, to the other side of the mouth. Shallow by the upper and lower muscle fiber composition. Unilateral cleft lip specimens show the affected side of the deep muscle in the fracture at the discontinuation of the lip from thick to thin. The shallow muscle is not only interrupted, the attachment Li Li also occurred dislocation, resulting in nasal column, nose deformity. The contralateral deep muscle was interrupted at the fissure, and the superficial myofibers were attached to the base of the columella, causing the columella to skew toward the contralateral side. Normal upper lip artery and the starting line are more constant, this group no anatomical abnormalities. Cleft lip specimens show that one side of the artery can not kiss the contralateral artery of the same name bow, but also caused abnormal walking. Conclusion: For unilateral complete cleft lip functional repair, ipsilateral subcutaneous stripping to reach the outer side of the alar wing, the distorted and dislocated superficial muscular tissue from the base of the alar wing and the outer periosteum of the alar wing on the separation and anatomical reduction.