先天性下唇下颌正中裂的手术治疗及文献回顾

目的探讨先天性下唇下颌正中裂畸形的修复和重建方法。方法将自体髂骨移植于下颌缺损，并用钛钉、钛板固定；将颏颈部固有的纤维条索组织瓣带蒂翻转，填充矫正颏部软组织畸形；颏颈部皮肤Z字改形缝合；术后行颌间牵引固定维持，并开展后续正畸治疗。结果本组2例患者的下颌骨颏部形态均得到明显改善，咬殆关系恢复正常并且稳定；颈部活动和姿态获得极大改善。患者对外形和功能恢复满意。结论先天性下唇下颌正中裂需分期手术治疗，I期行软组织裂隙治疗，Ⅱ期行骨骼重建。Ⅱ期手术通过自体髂骨移植，配合局部软组织瓣移植，可进一步改善咬殆功能及颏颈部的功能和外形。

Surgical treatment of the congenital median cleft of lower lip and mandible literature review

Objective To explore the repair method for median cleft of lower lip and mandible. Met hods Autologous iliac bone were transplanted to mandibular cleft and it was fixed with titanium screws. The inher- ent fibrous band in the neck and chin was rotated to correct the soft tissue deficiency. Z-plasty was performed on the chin and neck to break up the linear scar. Results The chin shape of 2 patients was improved significantly, in which occlusal relationship was corrected. Cervical movement was also improved. Two patients were all satisfied with the results. Conclusion The median cleft of lower lip and mandible need stage operation, soft tissue fissure should be treated in Period I, mandibular reconstruction should be performed in Period II. The occlusal function and cervical movement could be improved in Period II by autologous iliac bone and tissue flap.