单侧唇裂继发鼻畸形的手术矫正

目的 分析单侧唇裂鼻畸形产生机制,采用相应手术方法对不同年龄患者进行矫正治疗,探讨单侧唇裂鼻畸形手术效果的影响因素.方法 对患侧鼻翼软骨充分松解后与健侧鼻软骨缝合悬吊固定,在同侧鼻前庭黏膜皱褶处采用"Z"成形术,在鼻小柱基部及患侧鼻翼外侧基部的皮下及肌层悬吊固定.纠正鼻翼塌陷、鼻尖过低、鼻小柱偏斜等畸形.结果 56例患者中,鼻翼塌陷矫正满意者占80%,基本满意占18%;鼻尖高度改善满意占78%,基本满意占18%;鼻孔形态对称性及宽度满意占46%,基本满意占44%.总体满意度为94.6%.结论 唇裂继发鼻畸形矫正时对患侧鼻翼软骨的充分松解游离是关键环节,患侧鼻前庭黏膜皱褶不仅影响鼻部形态甚至通气功能,还可能使鼻畸形的表现更显突出,因而对鼻前庭黏膜皱褶的矫正也是十分重要的,尤其在矫正患侧鼻翼塌陷畸形方面有明显辅助作用.

Correction of nasal deformity in unilateral cleft lip

Objective To analyze the mechanism of nasal deformity and to correct the nasal deformity using appropriate operation accordingly.Methods The nasal skin was widely undermined from the nostril rim,to permit lifting the alar cartilage easily,and the alar cartilage was raised to its normal and symmetrical position and then sutured.A "Z" plasty was made on the ridge of nasal mucosa under nostril on the side of the cleft.Results A total of 56 cases were treated by the method above,and 94.6% of cases were evaluated as satisfaction.Conclusion It is very important to undermine the alar cartilage on the side of the cleft to achieve better results.The ridge of nasal mucosa under nostril on the side of the cleft affects not only the shape of nose tip,but also the function of respiration.Therefore,it is also important to correct the ridge of nasal mucosa.