• 廣西壯族自治區(qū)人民醫(yī)院整形外科（南寧，530021）;

目的探討榫卯型口輪匝肌肌瓣修復(fù)單側(cè)唇裂術(shù)后繼發(fā)人中嵴畸形的療效。 方法2009年1月－2011年8月，收治43例單側(cè)唇裂修復(fù)術(shù)后繼發(fā)人中嵴畸形患者。 男23例，女20例；年齡18～31歲，平均23.6歲。左側(cè)26例，右側(cè)17例。唇裂采用MillardⅠ式修復(fù)15例，MillardⅡ式修復(fù)28例。唇裂修復(fù)術(shù)至此次手術(shù)時(shí)間為15～30年，平均21.7年。術(shù)中切取雙側(cè)口輪匝肌肌瓣，水平分成上、下兩層；雙側(cè)下層肌瓣相互重疊縫合，上層肌瓣形成榫卯型結(jié)構(gòu)，縫合于皮下。 結(jié)果術(shù)后患者切口均Ⅰ期愈合。40例患者獲隨訪，隨訪時(shí)間6～34個(gè)月，平均13.4個(gè)月。雙側(cè)人中嵴隆起、對(duì)稱，人中凹形態(tài)接近正常，上唇動(dòng)態(tài)效果滿意。術(shù)后6個(gè)月38例明顯改善，2例改善不明顯。 結(jié)論榫卯型口輪匝肌肌瓣手術(shù)操作簡(jiǎn)便，修復(fù)單側(cè)唇裂術(shù)后繼發(fā)人中嵴畸形能較好恢復(fù)解剖結(jié)構(gòu)，術(shù)后獲得良好上唇外形和功能。

引用本文： 朱格非,麥慧. 榫卯型口輪匝肌肌瓣修復(fù)單側(cè)唇裂術(shù)后繼發(fā)人中嵴畸形. 中國(guó)修復(fù)重建外科雜志, 2012, 26(9): 1081-1083. doi: 復(fù)制

1. Garcia de Mitchell CA, Pessa JE, Schaverien MV, et al. The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg, 2008, 122(6): 1756-1760.
2. Cakir B, Gideroglu K, Akan M, et al. Jack-like eversion by splitting the orbicularis oris muscle for reconstruction of the philtral column in secondary cleft lip. Scand J Plast Reconstr Surg Hand Surg, 2009, 43(1): 8-15.
3. 張彬, 李克義, 牛懷恩, 等. 改良皮膚切口及口輪匝肌解剖學(xué)重建在先天性雙側(cè)唇裂修復(fù)術(shù)中的應(yīng)用. 山東醫(yī)藥, 2008, 48(8): 27-29.
4. 王佳崎, 趙敏, 熊斌, 等. 上唇肌瓣鑲嵌三層固定縫合修復(fù)單側(cè)唇裂人中嵴. 中華醫(yī)學(xué)美容雜志, 2000, 6(5): 267-268.
5. Kishi N, Tanaka S, Iida S, et al. The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg, 2012, 40(3): 215-222.
6. Housman TS, Berg D, Most SP, et al. Repair of the philtrum: an illustrative case series. J Cutan Med Surg, 2008, 12(6): 288-294.
7. Khandekar BV, Srinivasan S, Mokal NJ. Median cleft lip: A new method of surgical repair. Indian J Plast Surg, 2010, 43(1): 111-113.
8. Meyer E, Seyfer A. Cleft lip repair: technical refinements for the wide cleft. Craniomaxillofac Trauma Reconstr, 2010, 3(2): 81-86.
9. Ray TL, Chow S, Lee PK. Myocutaneous island pedicle “sling” flap for correction of central upper cutaneous (philtral) lip defects. Dermatol Surg, 2010, 36(5): 671-674.
10. Lim AA, Allam KA, Taneja R, et al. Construction of the philtral column using palmaris longus tendon. Plast Reconstr Surg, 2012, 129(2): 374e-375e.
11. Cho BC, Baik BS. Formation of philtral column using vertical interdigitation of orbicularis oris muscle flaps in secondary cleft lip. Plast Reconstr Surg, 2000, 106(5): 980-986.
12. 孫家明, 李薇薇, 喬群. 口輪匝肌垂直交叉法在繼發(fā)唇裂人中嵴重建中的應(yīng)用. 中華醫(yī)學(xué)美學(xué)美容雜志, 2007, 13(3): 179-180.
13. 翦新春, Miqdadi MMA, 陳順金, 等. 單側(cè)唇裂繼發(fā)畸形修復(fù)中口輪匝肌的重建. 中華醫(yī)學(xué)美學(xué)美容雜志, 2007, 13(4): 207-210.
14. 張奎啟, 韓輝, 林麗, 等. 口輪匝肌和人中形態(tài)的解剖學(xué)研究. 中華口腔醫(yī)學(xué)雜志, 1990, 25(6): 353-354.
15. Mishimagi T. Three-dimensional analysis of the morphology of philtrum and philtral dimple of unilateral cleft lip/cleft lip and palate patients before and after secondary cleft lip and nose repair. Kokubyo Gakkai Zasshi, 2010, 77(2): 128-139.
16. Kishi N, Tanaka S, Iida S, et al. Comprehensive evaluation of three-dimensional philtral morphology. Craniofac Surg, 2011, 22(5): 1606-1611.
  1. 1. Garcia de Mitchell CA, Pessa JE, Schaverien MV, et al. The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg, 2008, 122(6): 1756-1760.
  2. 2. Cakir B, Gideroglu K, Akan M, et al. Jack-like eversion by splitting the orbicularis oris muscle for reconstruction of the philtral column in secondary cleft lip. Scand J Plast Reconstr Surg Hand Surg, 2009, 43(1): 8-15.
  3. 3. 張彬, 李克義, 牛懷恩, 等. 改良皮膚切口及口輪匝肌解剖學(xué)重建在先天性雙側(cè)唇裂修復(fù)術(shù)中的應(yīng)用. 山東醫(yī)藥, 2008, 48(8): 27-29.
  4. 4. 王佳崎, 趙敏, 熊斌, 等. 上唇肌瓣鑲嵌三層固定縫合修復(fù)單側(cè)唇裂人中嵴. 中華醫(yī)學(xué)美容雜志, 2000, 6(5): 267-268.
  5. 5. Kishi N, Tanaka S, Iida S, et al. The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg, 2012, 40(3): 215-222.
  6. 6. Housman TS, Berg D, Most SP, et al. Repair of the philtrum: an illustrative case series. J Cutan Med Surg, 2008, 12(6): 288-294.
  7. 7. Khandekar BV, Srinivasan S, Mokal NJ. Median cleft lip: A new method of surgical repair. Indian J Plast Surg, 2010, 43(1): 111-113.
  8. 8. Meyer E, Seyfer A. Cleft lip repair: technical refinements for the wide cleft. Craniomaxillofac Trauma Reconstr, 2010, 3(2): 81-86.
  9. 9. Ray TL, Chow S, Lee PK. Myocutaneous island pedicle “sling” flap for correction of central upper cutaneous (philtral) lip defects. Dermatol Surg, 2010, 36(5): 671-674.
  10. 10. Lim AA, Allam KA, Taneja R, et al. Construction of the philtral column using palmaris longus tendon. Plast Reconstr Surg, 2012, 129(2): 374e-375e.
  11. 11. Cho BC, Baik BS. Formation of philtral column using vertical interdigitation of orbicularis oris muscle flaps in secondary cleft lip. Plast Reconstr Surg, 2000, 106(5): 980-986.
  12. 12. 孫家明, 李薇薇, 喬群. 口輪匝肌垂直交叉法在繼發(fā)唇裂人中嵴重建中的應(yīng)用. 中華醫(yī)學(xué)美學(xué)美容雜志, 2007, 13(3): 179-180.
  13. 13. 翦新春, Miqdadi MMA, 陳順金, 等. 單側(cè)唇裂繼發(fā)畸形修復(fù)中口輪匝肌的重建. 中華醫(yī)學(xué)美學(xué)美容雜志, 2007, 13(4): 207-210.
  14. 14. 張奎啟, 韓輝, 林麗, 等. 口輪匝肌和人中形態(tài)的解剖學(xué)研究. 中華口腔醫(yī)學(xué)雜志, 1990, 25(6): 353-354.
  15. 15. Mishimagi T. Three-dimensional analysis of the morphology of philtrum and philtral dimple of unilateral cleft lip/cleft lip and palate patients before and after secondary cleft lip and nose repair. Kokubyo Gakkai Zasshi, 2010, 77(2): 128-139.
  16. 16. Kishi N, Tanaka S, Iida S, et al. Comprehensive evaluation of three-dimensional philtral morphology. Craniofac Surg, 2011, 22(5): 1606-1611.