The Cleft Lateral Lip Element: Do Traditional Markings Result in Secondary Deformities?
The Cleft Lateral Lip Element: Do Traditional Markings Result in Secondary Deformities?
复制标题
唇裂元素：传统标记会导致继发畸形吗？
DOI：
10.1097/01.sap.0000069072.75463.bd
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发表时间：
2003
影响因子：
1.5
通讯作者：
J. Serletti
中科院分区：
文献类型：
--
作者：
J. Losee;Jessie C Selber;Nolis S. Arkoulakis;J. Serletti
在唇裂手术中，传统上有两种方法用来标记外侧唇上丘比特弓的高度。一种方法是测量从口腔接合处到非裂侧丘比特弓高度的距离，并将这个距离转置到裂侧侧唇元素上。第二种技术标志着丘比特的弓的高度在左侧侧面唇元素，白卷消失。作者认为这些技术在修复中可能导致残裂组织的畸形。在唇部丰满度衰减之前，在左侧侧唇元素上标记丘比特弓的高度，可以防止这种畸形。一项回顾性研究产生了一系列的17例患者继发性畸形的残裂组织在他们的修复。侧唇元的标记方法是通过图表复习确定的。然后患者接受二次手术，切除残留的裂组织，并使用初始技术进行修复。随机选取一组原发唇裂患者，使用作者的技术标记外侧唇部，同样评估修复中是否存在残留的唇裂组织。继发性畸形17例，单侧畸形14例，双侧畸形3例。在单侧病例中，7例采用三角形皮瓣修复，7例采用旋转推进修复。双侧病例采用改良的Millard技术修复。8例患者使用停止白卷标记外侧唇元，2例患者使用丘比特弓高度连接标记外侧唇元，7例患者使用未报道的方法。使用作者的技术，“对照组”和“二次修复”的病例都没有产生多余的裂组织。平均随访11个月（范围1 ~ 41个月）。作者认为，传统的丘比特弓高度标记在唇裂修复中可能会导致唇裂组织残留。这种畸形可以通过标记丘比特弓的高度在唇部丰满度衰减之前的侧面唇裂元素来预防。
In cleft surgery, two methods have traditionally been used to mark the height of cupid’s bow on the lateral lip element. One technique measures the distance from the oral commissure to the height of cupid’s bow on the noncleft side, and transposes this distance onto the cleft-side lateral lip element. The second technique marks the height of cupid’s bow on the cleft-side lateral lip element where the white roll disappears. The authors believe these techniques may result in deformities of residual cleft tissue in the repair. Marking the height of cupid’s bow on the cleft-side lateral lip element, just before the attenuation of lip fullness, can prevent this deformity. A retrospective study yielded a series of 17 patients with secondary deformities of residual cleft tissue in their repair. The method used to mark the lateral lip element was determined by chart review. Patients then underwent secondary surgery with excision of residual cleft tissue, and repair using the initial technique. A random group of primary cleft patients, repaired using the authors’ technique for marking the lateral lip element, was likewise evaluated for the presence of residual cleft tissue in the repair. Of the 17 cases of secondary deformities, 14 were unilateral and 3 were bilateral. Among the unilateral cases, seven were repaired with a triangular flap and seven by rotation advancement. The bilateral cases were repaired using the modified Millard technique. The lateral lip element was marked using cessation of the white roll in 8 patients, and the commissure to the height the of cupid’s bow in 2 patients, whereas in 7 patients the method was unreported. Using the authors’ technique, both “controls” repaired primarily and cases repaired secondarily resulted in no redundant cleft tissue. Average follow-up was 11 months (range, 1–41 months). The authors think that traditional markings for establishing the height of cupid’s bow on the cleft lateral lip element may result in residual cleft tissue in the repair. This deformity can be prevented by marking the height of cupid’s bow on the cleft lateral lip element just before the attenuation of lip fullness.