双侧唇红矩形瓣前唇原长双侧唇裂修复术

目的介绍双侧唇红矩形瓣前唇原长双侧唇裂修复术的应用。方法双侧唇裂患者29例，男性20例，女性9例。其中双侧完全裂15例，不完全裂11例，混合裂3例，均采用双侧唇红矩形瓣前唇原长法进行修复。首先采用传统的原长法原则修复唇白。修复唇红时，在两侧唇红设计形成包括黏膜和部分口轮匝肌的矩形瓣，并沿干湿唇交界线水平切开前唇，将两侧矩形瓣向下内旋转至前唇唇红对接缝合。缝合时口轮匝肌肌束的断端尽可能广阔而平整的接合，以恢复正常的环形结构。结果所有患者的创口均Ⅰ期愈合，上唇高度宽度适中，唇珠明显，无口哨畸形。结论该方法修复双侧唇裂，方法简单可靠，去除组织少，术后能获得较好的鼻唇外形，口唇功能较好，值得在临床推广。

Repair of the deformity of bilateral cleft lip with non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion

Objective To introduce experiences with non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion for repairing bilateral cleft lips. Methods 29 patients (20 males and 9 females) with bilateral cleft lips underwent operations of non-elongated cheiloplasty and rectangular mucomuscular complex flaps of double vermilion. There were 15 bilateral complete cleft lips, 11 bilateral incomplete cleft lips and 3 bilateral mixed cleft lips. The deformity of white lips was reconstructed with traditional non-elongated cheiloplasty. When repairing the vermilion, the rectangular mucomuscular complex flaps which included mucous membrane of vermilion and part of orbicularis oris in double vermilion were designed, and vermilion of fore lip was incised along boundary of wet lip and dry lip. Then rectangular mucomuscular complex flaps of double vermilion were rotated downward and inward to be sewn with fore lip. At the step, the end of orbicularis otis should be sewn widely and fitly in order to form a normal annular structure. Results The wounds of all the patients were healed at one stage. The height and width of patients' upper lips were proper and the center tubercles of the upper lips were obvious. No whistling deformity appeared. Conclusion The method for repairing bilateral cleft lips is simple and reliable. Less tissues could be excised and the satisfactory form and function of nose and lip could be achieved. It is worthy to be applied in clinical practice.