CAJ | 학술논문

目的：探讨根据口鼻轮廓线设计并完成单侧唇裂Ⅰ期整复的手术方法。方法利用裂隙侧口鼻弯曲轮廓线为手术切口的唇裂手术方式，对196例Ⅰ期单侧唇裂患者进行口唇畸形和鼻部畸形整体设计和矫正，包括：1）手术切口线设计在口鼻弯曲的轮廓线上，和弯曲轮廓线重叠，易于隐蔽；2）充分地剥离及松解组织畸形的异常附着；3）患侧鼻翼软骨和黏膜向内向上，鼻翼软骨内侧脚向外向下旋转，矫正患侧鼻翼软骨；4）唇部肌肉的重叠或褥式缝合重建患侧人中嵴的高度；5）保持人中嵴皮肤的完整性。观察术后的鼻唇效果和对称性。结果患者的患侧上唇形态、唇峰长短、鼻孔大小、鼻小柱形态、鼻翼形态和鼻底塌陷程度，较术前均有明显改善，鼻唇外形接近于正常外形，术后轮廓线上的瘢痕不明显，整复效果满意。结论根据口鼻轮廓线设计单侧唇裂Ⅰ期整复手术方案，能取得良好外形美观效果。
목적：탐토근거구비륜곽선설계병완성단측진렬Ⅰ기정복적수술방법。방법이용렬극측구비만곡륜곽선위수술절구적진렬수술방식，대196례Ⅰ기단측진렬환자진행구진기형화비부기형정체설계화교정，포괄：1）수술절구선설계재구비만곡적륜곽선상，화만곡륜곽선중첩，역우은폐；2）충분지박리급송해조직기형적이상부착；3）환측비익연골화점막향내향상，비익연골내측각향외향하선전，교정환측비익연골；4）진부기육적중첩혹욕식봉합중건환측인중척적고도；5）보지인중척피부적완정성。관찰술후적비진효과화대칭성。결과환자적환측상진형태、진봉장단、비공대소、비소주형태、비익형태화비저탑함정도，교술전균유명현개선，비진외형접근우정상외형，술후륜곽선상적반흔불명현，정복효과만의。결론근거구비륜곽선설계단측진렬Ⅰ기정복수술방안，능취득량호외형미관효과。
Objective??To?discussion?the?methods?and?clinical?efficacy?of?first?repair?surgery?according?to?the?lip?nasal?contour?line?design?of?unilateral?cleft?lip.?Methods??Use?of?contour?line??affected?side?lip?nasal??to??design?cleft?lip?to?surgery?operative?incision?and?comprehensive?repair?for?lip?nasal?deformity?of?196?patients?with?first?stage?unilateral?cleft?lip,?include:?1)?operation?incision?line?design?in?the?lip?nasal?contour?line?curved,?overlapping?and?bend?contours,?easily?concealed;?2)?fully?stripping?of?abnormal?attachment?tissue?deformity;?3)?affected?side?alar?cartilage?and?mucosal?inward,?outward?and?downward?rotation?of?the?medial?foot?of?alar?cartilage,?correction?of?deformities?of?alar?cartilage;?4)?the?lip?muscle?overlap?or?mattress?suture?reconstruction?affected?side?philtrum?crest?height;?5)?keeping?the?integrity?of?philtrum?crest?skin.?Observation?of?postoperative?nasal?lip?effect?and?symmetry.?Results???Patients?with?ipsilateral?upper?lip?shape,?lip?peak?length,?nostril?size,?the?morphology?of?nasal?columella,?nose?shape?and?nasal?base?collapse?degree,?were?significantly?improved?compared?with?preoperative,?nose?and?lip?shape?close?to?normal?shape,?postoperative?contour?line?of?the?scar?is?not?obvious,?plastic?effect?satisfaction.?Conclusion???According?to?the?lip?nasal?contour?line?design?and?comprehensive?repair?of?unilateral?cleft?lip,?can?achieve?good?appearance?effect.