肌肉平衡重建矫正鼻部对称性的短期临床效果评估

doi:10.7518/hxkq.2021.05.010

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (5): 560-565.doi: 10.7518/hxkq.2021.05.010

肌肉平衡重建矫正鼻部对称性的短期临床效果评估

刘颖蒙¹(), 陈宇¹, 张碧荷², 石冰¹, 李承浩¹()

^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
^2.北京大学口腔医院口腔颌面外科，北京 100000

收稿日期:2020-11-06 修回日期:2021-07-13 出版日期:2021-10-01 发布日期:2021-10-11
通讯作者: 李承浩 E-mail:22528257@qq.com;leechenghao_cn@163.com
作者简介:刘颖蒙，硕士，E-mail：22528257@qq.com
基金资助:
四川大学华西口腔医院临床研究项目(LCYJ2019-10);四川省科技厅重点项目(19ZDYF1430)

Short-term nasal symmetry repaired by force-balanced muscular reconstruction technique

Liu Yingmeng¹(), Chen Yu¹, Zhang Bihe², Shi Bing¹, Li Chenghao¹()

^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
^2.Dept. of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing 100000, China

Received:2020-11-06 Revised:2021-07-13 Online:2021-10-01 Published:2021-10-11
Contact: Li Chenghao E-mail:22528257@qq.com;leechenghao_cn@163.com
Supported by:
The Develop Program of Sichuan University(LCYJ2019-10);Key Program of Sichuan Provincial Department of Science and Technology(19ZDYF1430);Correspondence: Li Chenghao, E-mail: leechenghao_cn@163.com

摘要/Abstract

摘要： 目的

通过比较创新和传统两种肌肉重建技术联合鼻内固定术修复单侧继发鼻唇畸形术后短期鼻部对称性评估效果，为进一步改进唇裂二期手术治疗提供依据。

方法

选取60例单侧唇裂继发鼻唇畸形患者，年龄4~18岁，采用创新肌肉重建技术联合鼻内固定术修复28例，传统肌肉重建技术联合鼻内固定术修复32例，使用二维照片测量分析法，对比术前和术后7 d的短期效果。

结果

术后7 d，力矩平衡肌肉重建组相比于术前在鼻小柱偏斜角、裂隙侧的鼻翼切线角、鼻翼缘立体性有较好恢复，鼻底对称性、鼻孔宽度对称性、鼻孔高度对称性、鼻翼切线角对称性和鼻孔形状也有较大改善（P<0.05）。

结论

新肌肉重建技术联合鼻内固定术对单侧继发鼻唇畸形修复效果显著。

关键词: 单侧唇裂术后继发鼻唇畸形, 鼻部畸形, 二期手术, 力矩平衡肌肉重建

Abstract: Objective

This study aimed to compare the postoperative outcome of the new and classical muscular reconstruction technique combined with nasal internal-fixation method for secondary deformity post unilateral cleft lip repair. A rationale is provided for the further surgical improvement of secondary deformities.

Methods

Sixty patients aged 4-18 years with secondary unilateral cleft lip-nose deformity were involved in this research. The deformities of 28 patients were repaired using the muscular force balance technique through nasal internal fixation method, and 32 were repaired using classical muscular reconstruction technique. Two-dimensional analysis was used to evaluate the nose-lip morphology of pre- and post-operative patients through standardized photographs seven days after surgery.

Results

Compared with preoperative nasal morphology in the muscular force balance technique group, the 7-days postoperative results of this group showed the significantly improved short-term outcomes in the correction of columellar deflection, alar rim angle, nasal shape, and the symmetry of alar base width, nostril width, nostril height, alar rim angle (P<0.05).

Conclusion

The new muscular reconstruction technique with nasal internal-fixation method has a significant effect on nasal repair.

Key words: secondary deformity post unilateral cleft lip repair, nasal deformity, secondary repair, force-ba-lanced muscular reconstruction

中图分类号:

R?782.2

刘颖蒙, 陈宇, 张碧荷, 石冰, 李承浩. 肌肉平衡重建矫正鼻部对称性的短期临床效果评估[J]. 华西口腔医学杂志, 2021, 39(5): 560-565.

Liu Yingmeng, Chen Yu, Zhang Bihe, Shi Bing, Li Chenghao. Short-term nasal symmetry repaired by force-balanced muscular reconstruction technique[J]. West China Journal of Stomatology, 2021, 39(5): 560-565.

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参考文献 14

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测量项目	术前	术后	P值
CA/°	86.35±5.35	89.64±5.49	0.022
ABWR	1.19±0.31	1.01±0.09	0.007
NWR	1.23±0.22	1.06±0.18	0.001
NHR	0.83±0.17	0.92±0.13	0.002
ARA（裂隙侧）/°	57.40±5.95	73.70±5.67	<0.001
ARAR	0.95±0.10	1.06±0.11	<0.001
NS（裂隙侧）	0.63±0.16	0.96±0.27	<0.001

测量项目	传统肌肉重建组	力矩平衡肌肉重建组	P值
CA/°	88.44±4.69	89.64±5.49	NS
ABWR	0.96±0.14	1.01±0.09	NS
NWR	0.90±0.20	1.06±0.18	0.002
NHR	0.98±0.14	0.92±0.13	NS
ARA（裂隙侧）/°	61.39±6.21	73.70±5.67	NS
ARAR	1.04±0.10	1.06±0.11	NS
NS（裂隙侧）	1.07±0.25	0.96±0.27	NS

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肌肉平衡重建矫正鼻部对称性的短期临床效果评估

Short-term nasal symmetry repaired by force-balanced muscular reconstruction technique

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