鼻畸形矫正术在初期唇裂修复术中的应用评价

目的：观察术前已完成鼻牙槽塑形矫治患儿在初期唇裂修补术中同期行鼻畸形矫正术对术后鼻外形的美观与对称效果的影响。方法：选择已完成术前鼻牙槽塑形矫治患儿69例，均采用改良旋转推进唇裂修复术实施手术。术中根据患侧外鼻形态恢复状况，确定是否行鼻畸形矫正术，其中32例行鼻畸形矫正术，37例未行鼻畸形矫正术。2组均采用术后第4～5年面容照片打分方式进行鼻外形评定。评定结果采用SPSS10．0软件包进行配对t检验。结果：唇裂修复术同期行鼻畸形矫正组和未行鼻畸形矫正组患儿，术后第4～5年鼻外形的美观与对称性平均得分为70．66±10．89和64．14±10．63．鼻畸形矫正组术后鼻外形显著优于未行鼻畸形矫正组，2组差异有统计学意义（P〈O．05）。结论：唇裂修复术中同期行鼻畸形矫正术的患儿，其术后鼻外形的美观与对称性进一步改善，且对外鼻的生长发育无不良影响。

The efficacy of cartilage dissection and repositioning in primary nasal reconstruction in complete unilateral cleft lip patients receiving nasal molding

PURPOSE： To assess the efficacy of cartilage dissection and repositioning in primary nasal reconstruction on long-term nasal symmetry and shape in complete unilateral cleft lip patients who received nasal molding. METHODS： 69 complete unilateral cleft lip patients underwent nasoalveolar molding before primary cheiloplasty. The primary cheiloplasty was done by the same surgeon. 32 （32/69） patients received cartilage dissection and repositioning in primary nasal reconstruction at the same time. Photographs were taken and used to evaluate the results 4 to 5 years postoperatively .The data was analyzed with SPSS 10.0 software package. RESULTS： The results revealed that the nasal symmetry and shape was significantly improved 4 to 5 years postoperatively after primary cheiloplasty simultaneously with cartilage dissection and repositioning in primary nasal reconstruction in complete unilateral cleft lip patients. The score of the two groups were 70.66±10.89 and 64.14±10.63, respectively. There was significant difference between the two groups （P〈0.05）. CONCLUSION： Primary cheiloplasty performed simultaneously with cartilage dissection and repositioning in primary nasal reconstruction can help to promote nasal symmetry and better appearance on long-term at an early age. This study demonstrates that simultaneous primary rhinoplasty with cartilage dissection and repositioning in primary nasal reconstruction can be more effective for complete unilateral cleft lip patients and no interference with nasal growth was encountered. Supported by Medical Research Fund of Shcnzhen Science and Technology Bureau （Grant No.200602102）.