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目的应用口轮匝肌部分劈开并横褥式缝合的方法重建人中嵴,以提高唇裂继发畸形手术效果。方法 32例唇裂术后继发人中嵴畸形患者,根据上唇畸形情况按照MillardⅡ式设计手术切口或作直线瘢痕两侧梭形切口,全层切开上唇皮肤,创缘两侧作皮肤、肌肉间锐性分离,必要时切断鼻小柱基底部轮匝肌,行轮匝肌非全层劈开,两侧肌肉作横褥式缝合以抬高人中嵴。术后6个月评价手术效果。结果 32例均一期愈合;上唇延长,双侧人中嵴基本对称,人中凹较明显;唇、鼻外形满意,口轮匝肌运动时各部分协调。结论本手术方法较大程度保留了一期术后口轮匝肌的连续性,是唇裂继发畸形人中嵴重建的一种简单、有效方法。
Objective To reconstruct the crest of human crest by splitting the part of orbicularis muscle and transverse mattress suture to improve the secondary deformity effect of cleft lip. Methods Thirty-two patients with secondary crista deformity after cleft lip operation were enrolled. According to the upper lip deformity, the incision was made according to the Millard Ⅱ design or both sides of the linear scar. The upper lip skin was cut in full thickness. Sharp separation, if necessary, cut off the base of the columella orbicularis muscle, orbicularis muscle non-full split, both sides of the transverse muscle for suture to elevate the crest. Six months after surgery to evaluate the effect. Results All the 32 cases were cured in one time. The upper lip was prolonged. The middle crista of both sides were basically symmetrical. The concave of the human was more obvious. The lips and nose shape were satisfied. The orbicularis oris was coordinated with each other. CONCLUSION: This procedure retains the continuity of orbicularis oris muscle to a large extent and is a simple and effective method for reconstruction of crista of secondary deformity in cleft lip.