缺损两侧的唇黏膜瓣在修复上唇中部红唇凹陷性缺损中的应用

目的探讨缺损两侧的唇黏膜瓣在上唇中部红唇凹陷性缺损畸形修复中的应用价值。方法在上唇中部红唇凹陷性缺损两侧，红唇与黏膜交界处内侧设计横行反向三角形黏膜瓣，两瓣共蒂于红唇凹陷部位。在缺损正中后部，黏膜瓣画线下方设计“人”形切口。沿设计线切开，掀起黏膜瓣，在该瓣下及两侧上唇切口下方稍加游离口轮匝肌．使其有一定移动度。将两侧口轮匝肌在掀起的黏膜瓣蒂下方正中处对拢缝合。然后将两侧黏膜瓣向下旋转90°，插入其下的“人”形切口内，使上唇中部组织量进一步增加，并加深唇龈沟，而两瓣移植后的共同蒂部“猫耳”正好形成唇珠，逐层缝合切口。结果共26例，其中双侧唇裂术后继发红唇缺损18例，尊侧唇裂术后继发红唇凹陷畸形4例，先天性4例，术后伤口均I期愈合。修复后红唇凹陷处饱满，唇珠明显，上唇外形满意，手术瘢痕小明显。结论应用缺损两侧的唇黏膜瓣转移修复上唇中部红唇凹陷性缺损畸形及唇珠再造，为同类组织修复，效果理想、操作简便、应用范围广泛，对任何原因引起的上唇中部红唇凹陷性缺损畸形均可应用。

Application of bilateral lip mucosa flaps for central defect reconstruction of upper-lip vermilion

Objective To investigate the value of the new method with bilateral lip mueosa flaps for central defect reconstruction of upper-lip vermilion. Methods On both sides of the central defect of upper lip vermilion, reverse triangular flaps was designed below the junction between vermilion and mucosal. These two flaps had the common pedicle of vermilion depression site. Incisions of "(λ)" shape were de-signed below the defect area and the flaps included mucosa and submucous tissue. This mueosa flaps were raised and orbicularis otis muscles under the flaps were free moderately. Bilateral orbicularis oris muscles were sutured under the common pedicle of the two mucosa flaps. Then the bilateral mucosa flaps were ro-tated down 90° and inserted into the " (λ)" shape incisions to increase the tissue volume of the middle upper lip and deepen the labiogingival sulcus. The common pediele of the bilateral mucosa flaps was formed to the vermilion tubercle and then the incisions were sutured layer by layer. Results The technique was per-formed on 26 patients including 18 cases of upper-lip vermilion defect after repair of bilateral cleft lip,4 ca-ses of upper-lip vermilion defect after repair of unilateral cleft lip and 4 cases of congenital malformation. All the lip mucosa flaps survived completely without any complications. The vermilion, tubercle and shape of the lips were satisfactory after all cases were repaired and all incision scars were concealed. Con-clusions Using the lip mucosa flaps transfer to repair vermilion defect with the same tissue can obtain satisfactory appearance. The lip mucosa flaps are ideal for repairing of the lip vermilion defect and recove-ring of the profile of labial arch and vermilion tubercle. It can be used widely in any cases with the central defect of upper lip vermilion.