李娇 鲁勇

[摘要]目的：探讨口内外联合入路修复单侧微小型唇裂的治疗效果。方法：选择2018年1月-2019年1月笔者医院收治的4例单侧微小型唇裂患者为研究对象，采用口内外联合入路法进行微小型唇裂的修复，口内通过口腔前庭沟处切口进行口轮匝肌的重建修复，口外唇红部通过Z形切口纠正唇部畸形，上唇皮肤凹陷及鼻部畸形视情况进一步治疗。结果：4例患者切口均为甲级愈合，唇红缘连续，口轮匝肌重建良好，唇弓形态正常，唇凹陷及鼻部畸形得到了较大改善。结论：采用口内外联合入路可以在较小创伤的基础上，恢复单侧微小型唇裂患者唇部形态及结构，改善美观。

[关键词]单侧微小型唇裂;口内外入路;重建修复

[中图分类号]R782.2+1    [文献标志码]A    [文章编号]1008-6455（2021）04-0058-03

Clinical Study of Unilateral Microform Cleft Lip Repair Via the Use of Intraoral and Extra-oral Approaches

LI Jiao1， LU Yong2

（1.Department of Orthodontics;2.Department of Oral and Maxillofacial Surgery， the Affiliated Stomatology Hospital， Medical College of Nanjing University， Nanjing 210008， Jiangsu，China）

Abstract： Objective The aim of this study was to devise an operative technique for unilateral microform cleft lip repair via the use of intraoral and extra-oral approaches. Methods  From January 2018 to January 2019， 4 patients with cleft lip diagnosed as mini-microform cleft lip were recorded. All of them were treated by intra-oral and extra-oral surgical treatment in our department.The orbicularis oris muscle was reconstructed by intraoral vestibular groove incision， the lip deformity was corrected by Z-shaped incision， and the skin deformity and nasal deformity were further treated. Results  It provided an optimal functional result with correction of the cleft furrow， vermillion notch， and cleft nose deformity. The shape of lip was recovered well， and the functional effect could be obtained through the dissecting reconstruction of orbicular muscle of mouth. Conclusion  Intra-oral and extra-oral approaches can restore the lip shape and structure， and achieve aesthetic results with minimally invasive surgery.

Key words： unilateral microform cleft lip; intra-oral and extra-oral approaches; reconstruction

微小型唇裂是指发生在上唇的微小缺陷，与上唇的发育有关，主要表现为红唇的凹陷或者上唇皮肤的缺损凹陷，被认为是先天性唇裂中畸形程度最轻的一类唇裂，又称为微小型唇裂[1]。针对微小型唇裂的修复方式有很多种，主要包括传统的全层切开法，这种方式与唇裂的矫正方式比较类似，但是对于切口长度范围的设计进行了一定限制[2];此外，还有针对唇部畸形设计的内切法，用于纠正口轮匝肌的结构异常，但其缺点是对于上唇皮肤处的畸形没有改善[3]。针对微小型唇裂的修复，关键在于实现口轮匝肌的连续，其有利于上唇的运动，形成良好的唇部结构，在此基础上，对唇红部的凹陷也进行相应修复。……