CAJ | 학술논문

目的探讨尽可能减少白唇部皮肤切口瘢痕的单侧微小型唇裂(单侧Ⅰ度唇裂)的修复方法.方法遵循微创技术操作原则,采用鼻堤Z成形术切口,行白唇区、鼻基底区口轮匝肌浅面皮下剥离,部分离断降鼻肌并松解患侧鼻翼基部在上颌骨的粘连,切取患侧口轮匝肌瓣向内向上推进与健侧口轮匝肌重叠缝合,固定于鼻小柱基部患侧皮下深层,结合唇系带松解、去表皮唇黏膜下组织瓣填充于红唇凹陷部位以修复红唇唇裂.结果 7例先天性单侧微小型唇裂修复后均甲级愈合.后随访6～18个月,唇裂鼻堤、红唇凹陷修复效果明显,且患侧鼻孔宽大及唇高短缩畸形亦有改善.结论鼻堤切口结合去表皮唇黏膜下组织瓣修复单侧唇裂,可在尽可能避免白唇切口瘢痕的前提下,明显改善单侧微小型唇裂存在的鼻堤、红唇凹陷、鼻孔宽大畸形,并延长了患侧唇高,可达到满意的手术效果,并符合微创技术原则.
목적 탐토진가능감소백진부피부절구반흔적단측미소형진렬(단측Ⅰ도진렬)적수복방법.방법 준순미창기술조작원칙,채용비제Z성형술절구,행백진구、비기저구구륜잡기천면피하박리,부분리단강비기병송해환측비익기부재상합골적점련,절취환측구륜잡기판향내향상추진여건측구륜잡기중첩봉합,고정우비소주기부환측피하심층,결합진계대송해、거표피진점막하조직판전충우홍진요함부위이수복홍진진렬.결과 7례선천성단측미소형진렬수복후균갑급유합.후수방6～18개월,진렬비제、홍진요함수복효과명현,차환측비공관대급진고단축기형역유개선.결론 비제절구결합거표피진점막하조직판수복단측진렬,가재진가능피면백진절구반흔적전제하,명현개선단측미소형진렬존재적비제、홍진요함、비공관대기형,병연장료환측진고,가체도만의적수술효과,병부합미창기술원칙.
Objective To introduce a surgical procedure resulting in less scars for unilateral microform cleft lip.Methods A Z-plasty incision was designed at suffered agger nasi,and then subcutaneours dissection of suffered upper lip and basis nasi was performed.Releasing suffered alar nasi base from maxillary bone by partly severing the mesculus compressor naris,an orbicularis oculi flap was formed and fixed to the hypodermis of columella base for advancing to superior medial position and overlaying orbicularis oculi.The labial frenulum extension and vermillion submucoustissue flap plicature for filling incisura were carried out to correct the deformitiy of vermillion incisura.Results After 6-18 months follow-up,the wounds of 7 cases (aged 7-19 years) healed at the first grade.The deformity of unilateral subcutaneous celft lip,such as the agger nasi and vermillion incisura,widened nostril,and deficient abial height,was significantly improved.Conclusions Unilateral subcutaneous celft lip could be satisfactorily reconstructed by the surgical technique consisting of Z-plasty incision at agger nasi,orbicularis oculi flap advancing,labial frenulum extension and vermillion submucous tissue flap plicature,with less scar formation.