口轮匝肌对称重建整复单侧唇裂术后唇畸形的效果评价

doi:10.7518/hxkq.2021.06.011

华西口腔医学杂志 ›› 2021, Vol. 39 ›› Issue (6): 698-702.doi: 10.7518/hxkq.2021.06.011

口轮匝肌对称重建整复单侧唇裂术后唇畸形的效果评价

陈宇(), 刘颖蒙, 张碧荷, 郑谦, 石冰, 李承浩()

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:2021-01-02 修回日期:2021-09-09 出版日期:2021-12-01 发布日期:2021-12-03
通讯作者: 李承浩 E-mail:chenyu2096@foxmail.com;leechenghao_cn@163.com
作者简介:陈宇，住院医师，硕士，E-mail：chenyu2096@foxmail.com
基金资助:
四川大学华西口腔医院临床研究项目(LCYJ2019-10)

Force balance reconstruction of orbicularis oris in correction of unilateral cleft lip deformity

Chen Yu(), Liu Yingmeng, Zhang Bihe, Zheng Qian, Shi Bing, Li Chenghao()

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:2021-01-02 Revised:2021-09-09 Online:2021-12-01 Published:2021-12-03
Contact: Li Chenghao E-mail:chenyu2096@foxmail.com;leechenghao_cn@163.com
Supported by:
Clinical Research Project of West China Hospital of Stomatology, Sichuan University(LCYJ2019-10)

摘要/Abstract

摘要： 目的

创新单侧唇裂术后唇畸形的整复技术并评价其术后效果。

方法

单侧唇裂术后唇畸形患者44例纳入研究，按肌肉对称平衡修复理论指导重建口轮匝肌。利用照片测量人中偏斜角以及唇高、侧唇宽、唇峰点红唇厚度、唇峰至面中线距离的不对称率（即健侧/患侧的比值减1的绝对值，其值越小代表健患侧越对称）等指标以评价手术效果。

结果

44例单侧唇裂术后继发畸形的患者进行唇部整复术后，其人中偏斜角、唇高不对称率及唇峰点红唇厚度不对称率3个指标差异有统计学意义，均为术后小于术前（P<0.05）。

结论

新的手术方法术后健患侧的对称性较术前有了明显改善，术后短期效果显著，为单侧唇裂术后畸形的整复及口周肌力平衡的恢复，提供了新的思路。

关键词: 单侧唇裂术后唇畸形, 干湿唇切口入路, 肌肉重建, 肌力平衡

Abstract: Objective

Short-term outcome evaluation for the correction of unilateral cleft lip deformity with a new technique.

Methods

Forty-four patients with unilateral cleft lip deformity were included in the study and in which the orbicularis oris muscle was reconstructed to achieve the optimal force balance of reconstructed orbicularis oris. The photometric two-dimensional indexes, including the philtrum oblique angle and asymmetry ratios (lip height, lip width, vertical distance from the white roll to the vermilion bottom at the Cupid’s bow point, and vertical distance from the Cupid ’s bow points to facial midline), were employed to measure and evaluate the outcome.

Results

Several indexes showed statistically significant difference, and they included the philtrum oblique angle, asymmetry ratio of the lip height, and asymmetry ratio of the vertical distance from the white roll to the vermilion bottom at Cupid ’ s bow points (P<0.05).

Conclusion

The results suggested that the new muscle reconstruction technique can significantly improve the short-term outcome of the correction of unilateral cleft lip deformity.

Key words: unilateral cleft lip deformity, incision at the junction of dry and wet lips, muscle reconstruction, muscle strength balance

中图分类号:

R782.2⁺1

陈宇, 刘颖蒙, 张碧荷, 郑谦, 石冰, 李承浩. 口轮匝肌对称重建整复单侧唇裂术后唇畸形的效果评价[J]. 华西口腔医学杂志, 2021, 39(6): 698-702.

Chen Yu, Liu Yingmeng, Zhang Bihe, Zheng Qian, Shi Bing, Li Chenghao. Force balance reconstruction of orbicularis oris in correction of unilateral cleft lip deformity[J]. West China Journal of Stomatology, 2021, 39(6): 698-702.

图/表 4

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表 1

参考文献 22

1	Allori AC, Mulliken JB. Evidence-based medicine: secondary correction of cleft lip nasal deformity[J]. Plast Reconstr Surg, 2017, 140(1): 166e-176e.
2	Monson LA, Khechoyan DY, Buchanan EP, et al. Secondary lip and palate surgery[J]. Clin Plast Surg, 2014, 41(2): 301-309.
3	Cho BC. New technique for correction of the microform cleft lip using vertical interdigitation of the orbicularis oris muscle through the intraoral incision[J]. Plast Reconstr Surg, 2004, 114(5): 1032-1041.
4	Li L, Xie F, Ma T, et al. Reconstruction of philtrum using partial splitting and folding of orbicularis oris muscle in secondary unilateral cleft lip[J]. Plast Reconstr Surg, 2015, 136(6): 1274-1278.
5	Naidoo S, Bütow KW. Philtrum reconstruction in unilateral cleft lip repair[J]. Int J Oral Maxillofac Surg, 2019, 48(6): 716-719.
6	Lim AA, Allam KA, Taneja R, et al. Construction of the philtral column using palmaris longus tendon[J]. Plast Reconstr Surg, 2012, 129(2): 374e-375e.
7	Youn DY, Yun SH, Oh JW, et al. Formation of the philtral column with palmaris longus tendon in the correction of unilateral cleft lip nose deformity[J]. J Korean Soc Plast Reconstr Surg, 1997, 24(3): 495-502.
8	Yin N, Wu J, Chen B, et al. Muscle tension line concept in nasolabial muscle complex-based on 3-dimensional reconstruction of nasolabial muscle fibers[J]. J Craniofac Surg, 2015, 26(2): 469-472.
9	李承浩, 韩亚培, 石冰. 新旋转推进法重建鼻唇对称性的临床效果[J]. 中华医学美学美容杂志, 2019, 25(6): 447-451.
	Li CH, Han YP, Shi B. Effect of a novel rotating advancing method on reconstruction of nasal lip symmetry[J]. Chin J Med Aesth Cosmet, 2019, 25(6): 447-451.
10	李承浩, 石冰. 重建唇裂鼻唇对称性理论与技术的进展[J]. 中华医学美学美容杂志, 2019, 25(6): 530-531.
	Li CH, Shi B. Advances in reconstruction of nasolabial symmetry in cleft lip[J]. Chin J Med Aesth Cosmet, 2019, 25(6): 530-531.
11	Huang H, Han Y, Akinade T, et al. Force balance reconstruction of the orbicularis oris in unilateral incomplete cleft lip[J]. J Plast Reconstr Aesthet Surg, 2020, 73(9): 1717-1722.
12	Ettorre G, Weber M, Schaaf H, et al. Standards for digital photography in cranio-maxillo-facial surgery—Part Ⅰ: basic views and guidelines[J]. J Craniomaxillofac Surg, 2006, 34(2): 65-73.
13	Grewal NS, Kawamoto HK, Kumar AR, et al. Correction of secondary cleft lip deformity: the whistle flap procedure[J]. Plast Reconstr Surg, 2009, 124(5): 1590-1598.
14	Millard DR Jr, Latham RA. Improved primary surgical and dental treatment of clefts[J]. Plast Reconstr Surg, 1990, 86(5): 856-871.
15	Park CG, Ha B. The importance of accurate repair of the orbicularis oris muscle in the correction of unilateral cleft lip[J]. Plast Reconstr Surg, 1995, 96(4): 780-788.
16	Seagle MB, Furlow LT Jr. Muscle reconstruction in cleft lip repair[J]. Plast Reconstr Surg, 2004, 113(6): 1537-1547.
17	Rogers CR, Meara JG, Mulliken JB. The philtrum in cleft lip: review of anatomy and techniques for construction[J]. J Craniofac Surg, 2014, 25(1): 9-13.
18	Xu Y, Yang C, Schreuder WH, et al. Cephalometric analysis of craniofacial morphology and growth in unrepaired isolated cleft palate patients[J]. J Craniomaxillofac Surg, 2014, 42(8): 1853-1860.
19	Xu Y, Li J, Zhao S, et al. Four-dimensional changes of nasolabial positions in unilateral cleft lip and palate[J]. J Craniofac Surg, 2013, 24(2): 473-478.
20	Alt T, Knicker AJ, Strüder HK. The dynamic control ratio at the equilibrium point (DCRe): introducing relative and absolute reliability scores[J]. J Sports Sci, 2017, 35(7): 688-693.
21	Frère J, Göpfert B, Slawinski J, et al. Shoulder muscles recruitment during a power backward giant swing on high bar: a wavelet-EMG-analysis[J]. Hum Mov Sci, 2012, 31(2): 472-485.
22	Jones KJ, Kahlenberg CA, Dodson CC, et al. Arthroscopic capsular plication for microtraumatic anterior shoulder instability in overhead athletes[J]. Am J Sports Med, 2012, 40(9): 2009-2014.

测量项目	术前	术后	P值
人中偏斜角/°	7.65±1.44	4.93±1.16	0.000
唇高不对称率	0.127±0.037	0.066±0.018	0.001
侧唇宽不对称率	0.131±0.039	0.131±0.047	0.608
唇峰点红唇厚度不对称率	0.162±0.038	0.095±0.023	0.002
唇峰至面中线距离不对称率	0.780±0.602	0.380±0.097	0.051

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[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.

口轮匝肌对称重建整复单侧唇裂术后唇畸形的效果评价

Force balance reconstruction of orbicularis oris in correction of unilateral cleft lip deformity

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