个体化双侧唇裂修复术式的设计
作者：石 冰 王 晴
单位：
关键词：个体化术式；唇裂修复术；双侧唇裂；畸形分类
摘要 目的摘要 目的:探讨能使双侧唇裂修复术后唇及唇弓形态对称的个体化唇裂修复术式。方法:以双侧唇裂术前鼻小柱基部两侧至前唇唇峰点,以及两侧鼻翼基部至侧唇唇峰的距离是否对称作标准,将术前双侧唇裂的畸形特点分为5种类型,并针对每一种类型的畸形特点设计手术术式。结果:共设计出5种双侧唇裂修复术式,每一种术式仅适用一种双侧唇裂术前畸形的手术修复。结论:保证了双侧唇裂的术前畸形与其修复方法间有了明确的一一对应关系。
A Study of Individual Operation Designs for Bilateral Cleft Lip Repair
Shi Bing, Wang Qing
, http://www.100md.com
College of Stomatology, West China University of Medical Sciences
Abstract Objective: To design an individual operation procedure that can be adaptable to various deformity of ubilateral cleft lip and to assure the symmetry of lip and cupid's bow postoperatively in bilateral cleft lip. Methods: The distance from both sides of columella to cupid's bow peaks in prolabium as well as both sides of alar base to cupid's bow peaks in lateral lip has been used as standard of classification of the deformity of bilateral cleft lip, then operative procedurs respectively was designed in accordance with each special characteristic of bilateral deformity. Results: Five kinds of operation procedurs were designed, and each procedure was suitable only for one kind of preoperation deformity of bilateral cleft lip. Conclusion: The individual operation designs should be corresponding to the types of deformity before operation in bilateral cleft lip repair.
, 百拇医药
Key words:individual operation design bilateral cleft lip repair classification of cleft lip deformity
双侧唇裂的修复远较单侧唇裂困难,其难点一是对裂隙的修复失去了正常参照侧,故难以确保术后上唇的对称性。二是其畸形类型更加多样化。对于手术术式的设计与选择尚未能与反映个体畸形特点的指标紧密联系起来。
在对个体化单侧唇裂修复术式设计研究的基础上,笔者认为对双侧唇裂的修复,同样也应遵循两条基本原则,一是使修复后的上唇,特别是唇弓形态达到对称,二是有必要将唇裂的术前畸形状况,进行以手术设计依据为标准的分类,使术前畸形特点与修复术式设计间存有明确的一一对应的关系,这样才有可能使修复后的双侧唇裂具有接近自然的外观。
1 设计方法
, http://www.100md.com 1.1 解剖标志点的确定
以鼻小柱基部中点至前唇人中凹的中点连线作为上唇的理想中线,在鼻小柱基部和唇弓缘两侧分别距理想中线2～2.5 mm处标定为鼻小柱基部点和前唇两侧唇峰点。以下唇宽度二分之一的距离作标准,分别在两侧侧唇唇弓缘上标出唇峰点,并使两侧唇峰口角距相等,见图1。
1.2 双侧唇裂畸形的分型与术式设计
以两侧鼻小柱基部点和鼻翼基部点至前唇和侧唇两侧唇峰点的距离是否对称作标准,将现有的双侧唇裂分为5种类型。
1.2.1 Ⅰ型双侧唇裂及其术式设计 Ⅰ型双侧唇裂表现为AC=BD,MF=NH。
针对Ⅰ型畸形的特点,在前唇上,以鼻小柱两侧基部点至唇峰点的连线作前唇上的切口设计。在侧唇上,做从鼻翼基部点至裂隙缘和沿侧唇唇红与皮肤交界至唇峰点的切口设计。术中在保证侧唇唇峰点与前唇对应唇峰点高度相一致的基础上,修整唇瓣尖端的形态,使之与前唇侧缘切口相匹配并缝合(图2)。
图1 双侧唇裂修复术式设计的定点
R 鼻小柱基部中点,K 前唇人中切迹点,A 前唇右侧唇峰点,B 前唇左侧唇峰点,C 鼻小柱基部右侧点,D 鼻小柱基部左侧点,M 右侧鼻翼基部点,N 左侧鼻翼基部点,F 右侧唇唇峰点,H 左侧唇唇峰点,O1 右侧口角点,O2 左侧口角点
图2 Ⅰ型畸形的手术设计与术?Transfer interrupted!, 百拇医药
单位：
关键词：个体化术式；唇裂修复术；双侧唇裂；畸形分类
摘要 目的摘要 目的:探讨能使双侧唇裂修复术后唇及唇弓形态对称的个体化唇裂修复术式。方法:以双侧唇裂术前鼻小柱基部两侧至前唇唇峰点,以及两侧鼻翼基部至侧唇唇峰的距离是否对称作标准,将术前双侧唇裂的畸形特点分为5种类型,并针对每一种类型的畸形特点设计手术术式。结果:共设计出5种双侧唇裂修复术式,每一种术式仅适用一种双侧唇裂术前畸形的手术修复。结论:保证了双侧唇裂的术前畸形与其修复方法间有了明确的一一对应关系。
A Study of Individual Operation Designs for Bilateral Cleft Lip Repair
Shi Bing, Wang Qing
, http://www.100md.com
College of Stomatology, West China University of Medical Sciences
Abstract Objective: To design an individual operation procedure that can be adaptable to various deformity of ubilateral cleft lip and to assure the symmetry of lip and cupid's bow postoperatively in bilateral cleft lip. Methods: The distance from both sides of columella to cupid's bow peaks in prolabium as well as both sides of alar base to cupid's bow peaks in lateral lip has been used as standard of classification of the deformity of bilateral cleft lip, then operative procedurs respectively was designed in accordance with each special characteristic of bilateral deformity. Results: Five kinds of operation procedurs were designed, and each procedure was suitable only for one kind of preoperation deformity of bilateral cleft lip. Conclusion: The individual operation designs should be corresponding to the types of deformity before operation in bilateral cleft lip repair.
, 百拇医药
Key words:individual operation design bilateral cleft lip repair classification of cleft lip deformity
双侧唇裂的修复远较单侧唇裂困难,其难点一是对裂隙的修复失去了正常参照侧,故难以确保术后上唇的对称性。二是其畸形类型更加多样化。对于手术术式的设计与选择尚未能与反映个体畸形特点的指标紧密联系起来。
在对个体化单侧唇裂修复术式设计研究的基础上,笔者认为对双侧唇裂的修复,同样也应遵循两条基本原则,一是使修复后的上唇,特别是唇弓形态达到对称,二是有必要将唇裂的术前畸形状况,进行以手术设计依据为标准的分类,使术前畸形特点与修复术式设计间存有明确的一一对应的关系,这样才有可能使修复后的双侧唇裂具有接近自然的外观。
1 设计方法
, http://www.100md.com 1.1 解剖标志点的确定
以鼻小柱基部中点至前唇人中凹的中点连线作为上唇的理想中线,在鼻小柱基部和唇弓缘两侧分别距理想中线2～2.5 mm处标定为鼻小柱基部点和前唇两侧唇峰点。以下唇宽度二分之一的距离作标准,分别在两侧侧唇唇弓缘上标出唇峰点,并使两侧唇峰口角距相等,见图1。
1.2 双侧唇裂畸形的分型与术式设计
以两侧鼻小柱基部点和鼻翼基部点至前唇和侧唇两侧唇峰点的距离是否对称作标准,将现有的双侧唇裂分为5种类型。
1.2.1 Ⅰ型双侧唇裂及其术式设计 Ⅰ型双侧唇裂表现为AC=BD,MF=NH。
针对Ⅰ型畸形的特点,在前唇上,以鼻小柱两侧基部点至唇峰点的连线作前唇上的切口设计。在侧唇上,做从鼻翼基部点至裂隙缘和沿侧唇唇红与皮肤交界至唇峰点的切口设计。术中在保证侧唇唇峰点与前唇对应唇峰点高度相一致的基础上,修整唇瓣尖端的形态,使之与前唇侧缘切口相匹配并缝合(图2)。
图1 双侧唇裂修复术式设计的定点
R 鼻小柱基部中点,K 前唇人中切迹点,A 前唇右侧唇峰点,B 前唇左侧唇峰点,C 鼻小柱基部右侧点,D 鼻小柱基部左侧点,M 右侧鼻翼基部点,N 左侧鼻翼基部点,F 右侧唇唇峰点,H 左侧唇唇峰点,O1 右侧口角点,O2 左侧口角点
图2 Ⅰ型畸形的手术设计与术?Transfer interrupted!, 百拇医药