国际口腔医学杂志 ›› 2019, Vol. 46 ›› Issue (4): 383-386.doi: 10.7518/gjkq.2019039

• 中青年专家论坛 • 上一篇    下一篇

唇裂鼻畸形整复核心问题之华西观点

李承浩,李业平,石冰()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院唇腭裂外科 成都 610041
  • 收稿日期:2018-10-08 修回日期:2019-03-06 出版日期:2019-07-10 发布日期:2019-07-12
  • 作者简介:李承浩,副教授,博士,Email:leechenghao_cn@163.com
    专家简介:
    李承浩,四川大学华西口腔医学院副教授。美国德克萨斯州Baylor医学中心整形外科联合培养博士,美国俄亥俄州Cincinnati儿童医学中心整形外科学博士后,美国匹兹堡大学、宾夕法尼亚大学、霍普金斯医学中心访问学者。中华口腔医学会颌面外科专业委员会青年委员,中华口腔医学会颌面外科专业委员会唇腭裂专业委员会青年委员,西藏医学会常务理事。美国颅颌面研究会会员,第一作者和通讯作者发表SCI文章20余篇,主编《唇腭裂手术治疗学》、《唇鼻畸形整复石冰2017观点》,副主编《唇腭裂与面裂就医指南》,参编《唇鼻整形美容手术图谱》、《唇腭裂综合治疗学》、《唇腭裂正畸治疗》。主持和参加多个国家及院校级项目,获四川省科技进步二等奖1项。擅长鼻唇整形,特别是复杂鼻畸形的整复及辅助治疗。

West China’s viewpoints on core problems of cleft lip-nose repair

Li Chenghao,Li Yeping,Shi Bing()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cleft Lip and Palate Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2018-10-08 Revised:2019-03-06 Online:2019-07-10 Published:2019-07-12

摘要:

唇裂鼻畸形矫正一直是唇裂整复的热点与难点。手术医师对唇裂鼻畸形形成原因的认识不足与分歧、矫正技术的局限性以及术后效果维持与预判能力的缺乏是导致该问题愈趋复杂的主要原因。本文就唇裂鼻畸形几个核心的问题阐述和分享四川大学华西口腔医院唇腭裂外科的观点与认识,期望与同行共同厘清唇裂鼻畸形整复的核心,有助于推动与提高整体唇裂患者治疗效果。

关键词: 唇裂, 肌肉重建, 肌力平衡, 力矩, 畸形

Abstract:

The correction of cleft lip-nasal deformities has been the highlights and difficulty of cleft lip repair. The main reasons for complexity are the lack of understanding and divergence amongst surgeons on the panthomechanisms of the cleft lip nose, the limitation of surgical techniques, and the inability to maintain and predict the postoperative outcomes. This article aims to share and elaborate West China’s viewpoint on and understanding of several core problems of cleft lip and nose deformity, thereby clarifying the core problems of cleft lip-nose repair with peers which aids in promoting and improving the overall treatment of patients with cleft lip.

Key words: cleft lip, muscular reconstruction, biodynamics balance, torque, deformity

中图分类号: 

  • R782.2+1

图 1

鼻夹"

表 1

唇裂鼻畸形及其整复方案"

部位 畸形表现 整复技术
鼻背 突度不足 鼻背肋软骨移植
鼻尖 突度不足 鼻小柱肋软骨移植,彻底松解鼻翼基脚
附着后近中向缝合
侧方异位 同侧鼻腔衬里行V-Y推进
鼻翼 尾部旋转 鼻翼软骨穹窿部对缝,彻底松解下外侧
鼻翼软骨与梨状孔周围及上位软骨间附着
软骨发育不良 鼻翼部软骨移植
[1] 石冰, 李承浩 . 唇裂鼻畸形整复石冰2017观点[M]. 北京: 科学技术文献出版社, 2017.
Shi B, Li CH. Correction of cleft lip nose deformity: Shibing’s viewpoints in 2017[M]. Beijing: Scientific and Technical Documentation Press, 2017.
[2] Henry C, Samson T, Mackay D . Evidence-based medicine: the cleft lip nasal deformity[J]. Plast Reconstr Surg, 2014,133(5):1276-1288.
doi: 10.1097/PRS.0000000000000096
[3] Schnitt DE, Agir H, David DJ . From birth to maturity: a group of patients who have completed their protocol management. PartⅠ. Unilateral cleft lip and palate[J]. Plast Reconstr Surg, 2004,113(3):805-817.
[4] Wolfe SA, Nathan NR , MacArthur IR. The cleft lip nose: primary and secondary treatment[J]. Clin Plast Surg, 2016,43(1):213-221.
[5] Byrd HS, Salomon J . Primary correction of the unilateral cleft nasal deformity[J]. Plast Reconstr Surg, 2000,106(6):1276-1286.
[6] Kim SK, Cha BH, Lee KC , et al. Primary correction of unilateral cleft lip nasal deformity in Asian patients: anthropometric evaluation[J]. Plast Reconstr Surg, 2004,114(6):1373-1381.
[7] Haddock NT , McRae MH,Cutting CB. Long-term effect of primary cleft rhinoplasty on secondary cleft rhinoplasty in patients with unilateral cleft lip-cleft palate[J]. Plast Reconstr Surg, 2012,129(3):740-748.
doi: 10.1097/PRS.0b013e3182402e8e
[8] 肖苒, 徐慧芬 . 早期剥离术对鼻翼软骨生长发育影响的动物实验研究[J]. 华西口腔医学杂志, 1998,5(4):305-307.
Xiao R, Xu HF . Animal experiment of influence of early dissection on growth and development of alar cartilage[J]. West China J Stomatol, 1998,5(4):305-307.
[9] McDaniel JM, Alleyne B, Gosain AK . Secondary cleft nasoplasty at primary school age: quantitative evaluation of the efficacy of resorbable plates[J]. Plast Reconstr Surg, 2013,132(4):933-943.
doi: 10.1097/PRS.0b013e3182a053f1
[10] Greives MR, Camison L, Losee JE . Evidence-based medicine: unilateral cleft lip and nose repair[J]. Plast Reconstr Surg, 2014,134(6):1372-1380.
doi: 10.1097/PRS.0000000000000721
[11] Henry C, Samson T, Mackay D . Evidence-based medicine: the cleft lip nasal deformity[J]. Plast Reconstr Surg, 2014,133(5):1276-1288.
doi: 10.1097/PRS.0000000000000096
[12] Lee DW, Choi BK, Park BY . Seven fundamental procedures for definitive correction of unilateral secondary cleft lip nasal deformity in soft tissue aspects[J]. J Oral Maxillofac Surg, 2011,69(11):e420-e430.
[13] Basta MN, Goldstein JA, Wilson AJ , et al. A modified V-Y chondromucosal composite flap for correction of secondary cleft nasal deformity: photogrammetric analysis of a case-control study[J]. Plast Reconstr Surg, 2014,134(1):94-101.
doi: 10.1097/PRS.0000000000000282
[14] Patel KB, Mulliken JB . Correction of the vestibular web during primary repair of unilateral cleft lip[J]. Plast Reconstr Surg, 2014,134(4):600e-607e.
doi: 10.1097/PRS.0000000000000549
[15] Matsuo K, Hirose T, Otagiri T , et al. Repair of cleft lip with nonsurgical correction of nasal deformity in the early neonatal period[J]. Plast Reconstr Surg, 1989,83(1):25-31.
[16] Nakajima T, Yoshimura Y . Secondary repair of unilateral cleft lip nose deformity with bilateral reverse- U access incision[J]. Br J Plast Surg, 1998,51(3):176-180.
[17] Yeow VK, Chen PK, Chen YR , et al. The use of nasal splints in the primary management of unilateral cleft nasal deformity[J]. Plast Reconstr Surg, 1999,103(5):1347-1354.
[18] Byrd HS, El-Musa KA, Yazdani A . Definitive repair of the unilateral cleft lip nasal deformity[J]. Plast Reconstr Surg, 2007,120(5):1348-1356.
[19] Guyuron B.MOC-PS (SM) CME article: late cleft lip nasal deformity[J].Plast Reconstr Surg, 2008,121(4 Suppl):1-11.
[20] 石冰 . 中国人唇裂鼻畸形整复的思路与术式设计[J]. 华西口腔医学杂志, 2012,30(2):111-114.
Shi B . The thinking and design techniques for Chinese cleft lip nasal deformity[J]. West China J Stomatol, 2012,30(2):111-114.
[1] 李业平,郑谦,尹恒,郭春丽,石冰,李承浩. 影响单侧唇裂鼻畸形二期整复主观评价结果的鼻测量指标探究[J]. 国际口腔医学杂志, 2019, 46(4): 407-412.
[2] 刘艳丽,赵薇,张碧莹,安晓莉. 生长发育期骨性Ⅲ类错畸形骨支抗上颌前牵引的研究进展[J]. 国际口腔医学杂志, 2019, 46(1): 112-118.
[3] 张文旗, 王红, 韩钰, 杨双燕, 王瑞芳, 王春玲. 错牙合畸形早期防治知信行的现状调查[J]. 国际口腔医学杂志, 2018, 45(4): 403-407.
[4] 林文雄, 苏振民, 汪城河, 刘长江, 吴雅莹. 多瓣法整复大口畸形的临床应用[J]. 国际口腔医学杂志, 2017, 44(5): 573-575.
[5] 孙丞君, 许方清, 陈阳平, 刘丰艺, 罗佳英, 夏彬彬. 错牙合畸形对城市和农村儿童日常生活质量影响的研究[J]. 国际口腔医学杂志, 2017, 44(3): 304-309.
[6] 罗恩. 髁突骨软骨瘤及其继发牙颌面畸形的治疗[J]. 国际口腔医学杂志, 2017, 44(2): 130-134.
[7] 邹静1 秦满2 汪俊3 黄华4 林居红5 周学东. 儿童常见牙病与错牙合畸形[J]. 国际口腔医学杂志, 2016, 43(6): 619-623.
[8] 石冰. 2种隐形切口在唇裂术后继发畸形整复中的设计与应用[J]. 国际口腔医学杂志, 2016, 43(4): 371-376.
[9] 谭俭琴 唐正龙. 手术优先治疗牙颌面畸形的研究进展[J]. 国际口腔医学杂志, 2016, 43(1): 99-.
[10] 李海鹏1 王予江1 宁文杰2 朱志农1 郭美玲3. 单侧完全性唇裂鼻底修复的临床研究进展[J]. 国际口腔医学杂志, 2016, 43(1): 95-.
[11] 张伟 何克飞 朱钧一 王宇帆 蔡旭 赵怡芳. 中国脉管性疾病研究文献分析[J]. 国际口腔医学杂志, 2015, 42(6): 647-651.
[12] 于涛,李永诚,张露,王晓卫,石冰. 基于口鼻轮廓线行Ⅰ期单侧唇裂手术[J]. 国际口腔医学杂志, 2015, 42(5): 503-506.
[13] 石冰. 单侧唇裂的个体化整复[J]. 国际口腔医学杂志, 2015, 42(5): 497-502.
[14] 郭兴,马玉蓉,李和顺,郭永杰,石冰. 唇粘连术对新生儿唇腭裂修复的影响[J]. 国际口腔医学杂志, 2015, 42(5): 507-509.
[15] 居来提·吐尔逊,古丽,艾尼瓦尔·米吉提,阿地力·莫明. 同源异型盒基因1的基因多态性与非综合征性唇腭裂的关联研究[J]. 国际口腔医学杂志, 2015, 42(5): 510-513.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!