无鼻翼切口的Mulliken法修复双侧完全性唇裂唇鼻畸形

目的:探讨无鼻翼切口的Mul l i ken术式修复双侧完全性唇裂唇鼻畸形术后美容效果。方法:应用原长法的原则进行唇裂整复,术中恢复口轮匝肌的连续性,并行牙龈沟的再造及鼻底的封闭,利用侧唇的粘膜肌肉瓣修复唇珠,通过裂缘和前唇切口将大翼软骨、侧鼻软骨与粘膜和鼻翼皮肤潜行剥离,贯穿缝合上提并固定大翼软骨内侧脚,贯穿缝合将一侧大翼软骨外侧脚悬吊固定至对侧鼻软骨,同期初步矫正鼻畸形。结果:36例患者切口均Ⅰ期愈合,随访3个月～1年,前颌骨均有不同程度的回缩,人中明显,唇珠丰满,红唇缘整齐,鼻小柱得以延长,鼻翼塌陷得以纠正,鼻畸形有一定程度的改善。结论:采用无鼻翼切口的Mul l i ken法修复双侧完全性唇裂同期矫正鼻畸形,可获得良好的唇鼻部效果。

Restitution of nasal and lip deformity with mulliken's style without incision in the alae of the nose associated with a bilateral complete cleft lip

Objective Using the Mulliken method but no incision in the alae of the nose to correct cleft lip and nasal deformity at one-stage in restitution of congenital bilateral complete cleft lip and to explore cosmetic operative effect.Methods The design principle of cleft lip restitution was keeping the length of prolabium.During operation,the orbicularis oris muscle was dissected and replaced,the gingival sulcus was recyclinged and the nasal botton was closed.Repairing the lip beads with mucosal and muscle flap of both sides of lip.stripping the cartilage of the nosal wing and the side nose through the incision of split edge and front lip.suturing inside base and maked rised,then suture one-side nasal wing cartilage to another side nose’s and correct nasal deformity at one-stage.Results Thirty-six patients were treated with this surgical method,the incision was all healed better,through three month to one year’s followed up,36 of this cases showed satisfactory results with the front jaw was declined at some degree,regularity of red labial margin,nice phitrum,turgor vitalis of vermilion of the lip,their collapse ala nasi significantly improved and the columella nasi were lengthened,their nasal deformity were partly improved.Conclusion The goood effects could be achieved when using Mulliken method but no incision in the alae of the nose to repair bilateral complete cleft lip and correct nasal deformity at one-stage.