榫卯型口輪匝肌肌瓣修復單側唇裂術后繼發人中嵴畸形_《中國修復重建外科雜志》

作者：

朱格非 , 麥慧

廣西壯族自治區人民醫院整形外科（南寧，530021）;

關鍵詞：

唇裂繼發畸形口輪匝肌肌瓣人中嵴畸形

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目的探討榫卯型口輪匝肌肌瓣修復單側唇裂術后繼發人中嵴畸形的療效。方法2009年1月－2011年8月，收治43例單側唇裂修復術后繼發人中嵴畸形患者。男23例，女20例；年齡18～31歲，平均23.6歲。左側26例，右側17例。唇裂采用MillardⅠ式修復15例，MillardⅡ式修復28例。唇裂修復術至此次手術時間為15～30年，平均21.7年。術中切取雙側口輪匝肌肌瓣，水平分成上、下兩層；雙側下層肌瓣相互重疊縫合，上層肌瓣形成榫卯型結構，縫合于皮下。結果術后患者切口均Ⅰ期愈合。40例患者獲隨訪，隨訪時間6～34個月，平均13.4個月。雙側人中嵴隆起、對稱，人中凹形態接近正常，上唇動態效果滿意。術后6個月38例明顯改善，2例改善不明顯。結論榫卯型口輪匝肌肌瓣手術操作簡便，修復單側唇裂術后繼發人中嵴畸形能較好恢復解剖結構，術后獲得良好上唇外形和功能。

引用本文： 朱格非,麥慧. 榫卯型口輪匝肌肌瓣修復單側唇裂術后繼發人中嵴畸形. 中國修復重建外科雜志, 2012, 26(9): 1081-1083. doi: 復制

1.	Garcia de Mitchell CA, Pessa JE, Schaverien MV, et al. The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg, 2008, 122(6): 1756-1760.
2.	Cakir B, Gideroglu K, Akan M, et al. Jack-like eversion by splitting the orbicularis oris muscle for reconstruction of the philtral column in secondary cleft lip. Scand J Plast Reconstr Surg Hand Surg, 2009, 43(1): 8-15.
3.	張彬, 李克義, 牛懷恩, 等. 改良皮膚切口及口輪匝肌解剖學重建在先天性雙側唇裂修復術中的應用. 山東醫藥, 2008, 48(8): 27-29.
4.	王佳崎, 趙敏, 熊斌, 等. 上唇肌瓣鑲嵌三層固定縫合修復單側唇裂人中嵴. 中華醫學美容雜志, 2000, 6(5): 267-268.
5.	Kishi N, Tanaka S, Iida S, et al. The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg, 2012, 40(3): 215-222.
6.	Housman TS, Berg D, Most SP, et al. Repair of the philtrum: an illustrative case series. J Cutan Med Surg, 2008, 12(6): 288-294.
7.	Khandekar BV, Srinivasan S, Mokal NJ. Median cleft lip: A new method of surgical repair. Indian J Plast Surg, 2010, 43(1): 111-113.
8.	Meyer E, Seyfer A. Cleft lip repair: technical refinements for the wide cleft. Craniomaxillofac Trauma Reconstr, 2010, 3(2): 81-86.
9.	Ray TL, Chow S, Lee PK. Myocutaneous island pedicle “sling” flap for correction of central upper cutaneous (philtral) lip defects. Dermatol Surg, 2010, 36(5): 671-674.
10.	Lim AA, Allam KA, Taneja R, et al. Construction of the philtral column using palmaris longus tendon. Plast Reconstr Surg, 2012, 129(2): 374e-375e.
11.	Cho BC, Baik BS. Formation of philtral column using vertical interdigitation of orbicularis oris muscle flaps in secondary cleft lip. Plast Reconstr Surg, 2000, 106(5): 980-986.
12.	孫家明, 李薇薇, 喬群. 口輪匝肌垂直交叉法在繼發唇裂人中嵴重建中的應用. 中華醫學美學美容雜志, 2007, 13(3): 179-180.
13.	翦新春, Miqdadi MMA, 陳順金, 等. 單側唇裂繼發畸形修復中口輪匝肌的重建. 中華醫學美學美容雜志, 2007, 13(4): 207-210.
14.	張奎啟, 韓輝, 林麗, 等. 口輪匝肌和人中形態的解剖學研究. 中華口腔醫學雜志, 1990, 25(6): 353-354.
15.	Mishimagi T. Three-dimensional analysis of the morphology of philtrum and philtral dimple of unilateral cleft lip/cleft lip and palate patients before and after secondary cleft lip and nose repair. Kokubyo Gakkai Zasshi, 2010, 77(2): 128-139.
16.	Kishi N, Tanaka S, Iida S, et al. Comprehensive evaluation of three-dimensional philtral morphology. Craniofac Surg, 2011, 22(5): 1606-1611.

1. Garcia de Mitchell CA, Pessa JE, Schaverien MV, et al. The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg, 2008, 122(6): 1756-1760.
2. Cakir B, Gideroglu K, Akan M, et al. Jack-like eversion by splitting the orbicularis oris muscle for reconstruction of the philtral column in secondary cleft lip. Scand J Plast Reconstr Surg Hand Surg, 2009, 43(1): 8-15.
3. 張彬, 李克義, 牛懷恩, 等. 改良皮膚切口及口輪匝肌解剖學重建在先天性雙側唇裂修復術中的應用. 山東醫藥, 2008, 48(8): 27-29.
4. 王佳崎, 趙敏, 熊斌, 等. 上唇肌瓣鑲嵌三層固定縫合修復單側唇裂人中嵴. 中華醫學美容雜志, 2000, 6(5): 267-268.
5. Kishi N, Tanaka S, Iida S, et al. The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg, 2012, 40(3): 215-222.
6. Housman TS, Berg D, Most SP, et al. Repair of the philtrum: an illustrative case series. J Cutan Med Surg, 2008, 12(6): 288-294.
7. Khandekar BV, Srinivasan S, Mokal NJ. Median cleft lip: A new method of surgical repair. Indian J Plast Surg, 2010, 43(1): 111-113.
8. Meyer E, Seyfer A. Cleft lip repair: technical refinements for the wide cleft. Craniomaxillofac Trauma Reconstr, 2010, 3(2): 81-86.
9. Ray TL, Chow S, Lee PK. Myocutaneous island pedicle “sling” flap for correction of central upper cutaneous (philtral) lip defects. Dermatol Surg, 2010, 36(5): 671-674.
10. Lim AA, Allam KA, Taneja R, et al. Construction of the philtral column using palmaris longus tendon. Plast Reconstr Surg, 2012, 129(2): 374e-375e.
11. Cho BC, Baik BS. Formation of philtral column using vertical interdigitation of orbicularis oris muscle flaps in secondary cleft lip. Plast Reconstr Surg, 2000, 106(5): 980-986.
12. 孫家明, 李薇薇, 喬群. 口輪匝肌垂直交叉法在繼發唇裂人中嵴重建中的應用. 中華醫學美學美容雜志, 2007, 13(3): 179-180.
13. 翦新春, Miqdadi MMA, 陳順金, 等. 單側唇裂繼發畸形修復中口輪匝肌的重建. 中華醫學美學美容雜志, 2007, 13(4): 207-210.
14. 張奎啟, 韓輝, 林麗, 等. 口輪匝肌和人中形態的解剖學研究. 中華口腔醫學雜志, 1990, 25(6): 353-354.
15. Mishimagi T. Three-dimensional analysis of the morphology of philtrum and philtral dimple of unilateral cleft lip/cleft lip and palate patients before and after secondary cleft lip and nose repair. Kokubyo Gakkai Zasshi, 2010, 77(2): 128-139.
16. Kishi N, Tanaka S, Iida S, et al. Comprehensive evaluation of three-dimensional philtral morphology. Craniofac Surg, 2011, 22(5): 1606-1611.

《中國修復重建外科雜志》

榫卯型口輪匝肌肌瓣修復單側唇裂術后繼發人中嵴畸形

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