CAJ | 학술논문

目的观察双侧唇裂同期修复唇鼻畸形的远期效果.方法以16例先天性完全性双侧唇裂患儿为实验组,选取30例正常儿童为对照组,均在修复唇裂的同时在鼻唇角部位做V-Y成形术,解剖和保护鼻小柱前唇动脉,以确保前唇血运,显露及矫正错位的两侧鼻翼软骨并相互缝合,修复鼻畸形.术后10年随访时拍摄面部正、侧及后仰位像片,并测量鼻唇部解剖标志点的直线距离和角度值,与对照组正常儿童进行比较,以评估手术效果.结果实验组患儿鼻形态可以令人接受,远期效果稳定.但与正常同龄对照组测量数据比较,鼻小柱及鼻长相等,其中鼻宽度、鼻小柱宽度、鼻尖突度、鼻唇角均大于正常值(P＜0.05).结论在仔细解剖、妥善保护鼻小柱前唇动脉及前唇血运的前提下,同期修复双侧唇裂和鼻畸形,可以获得令人接受和稳定的远期效果,是较为可取的修复方法之一.
목적 관찰쌍측진렬동기수복진비기형적원기효과.방법 이16례선천성완전성쌍측진렬환인위실험조,선취30례정상인동위대조조,균재수복진렬적동시재비진각부위주V-Y성형술,해부화보호비소주전진동맥,이학보전진혈운,현로급교정착위적량측비익연골병상호봉합,수복비기형.술후10년수방시박섭면부정、측급후앙위상편,병측량비진부해부표지점적직선거리화각도치,여대조조정상인동진행비교,이평고수술효과.결과 실험조환인비형태가이령인접수,원기효과은정.단여정상동령대조조측량수거비교,비소주급비장상등,기중비관도、비소주관도、비첨돌도、비진각균대우정상치(P＜0.05).결론 재자세해부、타선보호비소주전진동맥급전진혈운적전제하,동기수복쌍측진렬화비기형,가이획득령인접수화은정적원기효과,시교위가취적수복방법지일.
Objective To explore the method to correct nasal deformity of the bilateral complete cleft lip and to eveluate the benefits of this teachnique.Methods Sixteen patients with the bilateral complete cleft lip were consecutively chosen to correct the nasal deformity of the bilateral complete cleft lip.We performed an open approach to facilitate alar cartilage manipulation while repairing the bilateral complete cleft lip,and elevated the prolabial flap for reconstructing the continuity of orbicularis oris musele artery by anatomizing and protecting the prolabial-columellar artery.Nasal columella length and wideth,nasal wideth,ratio of nasal length to face length,ratio of nasal wideth to the distence of nasolabial angle were analyzed after a minimum of 10 years after surgery.These were compared with those in a normal,age-matched control group.Results Appreance of nose and lip of 16 patients after surgery were satisfying and long-term results were good by following-up for 10 years.Columellar length and ratio of nasal length to face length were not significantly different from that of the control group.Nasal wideth,columella wideth,tip projetion and nasolabial angle were all significantly greater in the cleft group than the normal (P＜0.05).Conclusions Prolabial flap manipulation is a safe approach by using anatomizing the columellar-labial artery.This teachnique is effective and yields good long-term results.