The Importance of Accurate Repair of the Orbicularis Oris Muscle in the Correction of Unilateral Cleft Lip
The Importance of Accurate Repair of the Orbicularis Oris Muscle in the Correction of Unilateral Cleft Lip
复制标题
口轮匝肌精准修复在单侧唇裂矫正中的重要性
DOI：
10.1097/00006534-199509001-00003
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发表时间：
1993
影响因子：
3.6
通讯作者：
B. Ha
中科院分区：
文献类型：
--
作者：
C. Park;B. Ha
大多数唇裂修复的尝试和努力都是针对皮肤切口的。近年来，口轮匝肌修复的重要性越来越受到重视。设计良好的皮肤切口与简单的修复口轮匝肌已经产生了相当大的改善上唇的外观，但是，修复的上唇似乎改变其形状异常的运动，并有一种趋势，随着年龄的增长，如果口轮匝肌没有得到精确和准确的修复变形。解剖正常上唇和单侧唇裂的尸体，我们可以发现两个不同的组成部分口轮匝肌，浅和深的组成部分。一个是牵开器，另一个是唇的收缩器。在唇运动过程中，它们相互之间有对抗作用。我们也可以在手术过程中识别唇裂患者肌肉的这两种不同成分。我们认为，这两种不同的功能部件之间的连接不准确和混合，会使修复后的嘴唇变形和不平衡，这将在生长过程中变得更糟。通过识别和分别修复口轮匝肌的两个不同的肌肉成分（即，用内侧上的相应部件修复外侧上的浅表和深部部件），可以获得上唇的动态和三维构型的更好结果，并且可以避免随着患者的成长而出现不利的变形。本文报告了126例单侧唇裂患者按本文方法行唇裂修补术，其中20例随访10年以上。结论：口轮匝肌的深、浅两部分的准确分离修复，是获得唇平衡和修复后唇正常生长的关键。（Plast。重建96：780，1995）。
Most of the attempts and efforts in cleft lip repair have been directed toward the skin incision. The importance of the orbicularis oris muscle repair has been emphasized in recent years. The well-designed skin incision with simple repair of the orbicularis oris muscle has produced a considerable improvement in the appearance of the upper lip; however, the repaired upper lip seems to change its shape abnormally in motion and has a tendency to be distorted with age if the orbicularis oris muscle is not repaired precisely and accurately. Following the dissection of the normal upper lip and unilateral cleft lip in cadavers, we could find two different components in the orbicularis oris muscle, a superficial and a deep component. One is a retractor and the other is a constrictor of the lip. They have antagonistic actions to each other during lip movement. We also can identify these two different components of the muscle in the cleft lip patient during operation. We thought inaccurate and mixed connection between these two different functional components could make the repaired lip distorted and unbalanced, which would get worse during growth. By identification and separate repair of the two different muscular components of the orbicularis oris muscle (i.e., repair of the superficial and deep components on the lateral side with the corresponding components on the medial side), better results in the dynamic and three-dimensional configuration of the upper lip can be achieved, and unfavorable distortion can be avoided as the patients grow. Cleft lip repair has been performed by the authors' method in 126 patients with unilateral cleft lip, among whom 20 patients have been followed for over 10 years. We have obtained the following conclusion: the accurate separate repair of the superficial and deep portions of the orbicularis oris muscle is essential to obtain balanced lips and normal growth of the repaired lips. (Plast. Reconstr. Surg. 96: 780, 1995.)