The Comprehensive Correction Of The Secondary Lip-nasal Deformities Of Cleft Lip

Secondary cleft lip deformities of the diversity and flexibility of operation to the clinical variability of the treatment of a doctor brought many problems.The secondary lip-nasal deformities present inevitably in the vast majority of cleft lip patients,due to the inherent deficiency,the option of the time and method of the first correction,and the surgery skill.The typical secondary deformities consist of notch vermilion,short lip,distorted vermilion and unsatisfactory scarring,asymmetrical nostrils,the deformity of the nasal tip,columella shortened and deciated,the nose alar dome sunk on the cleft side,the lateral crus displaced laterally,and so on.The manifestation of the secondary deformities is so varied that the corresponding repairing is complex.The purpose of this study of the normal measurement of nasal soft tissue in patients with cleft lip and nose after a form of soft tissue measurments restorastion comparison and the second phase the degree of preoperative deformity paramters,a betters understanding of the extent and patterns of malformations.Thus finding effective methods of clinical surgery.Objective:1,Millard method repair unilateral complete cleft lip in children with postoperative morphometric study of the nose,through the use of Millard repair the deformity after the assessment,based on this method to study the repair of secondary deformities of the formation of the characteristics and laws.2,Through the secondary cleft lip deformity in patients with cleft lip deformity preoperative clinical assessment and screening parameters to assess the application of more mature way to join together to repair and improve them,as a correction of secondary deformities of cleft lip an integrated approach.To further assess the clinical application of the integrated effect of repair methods.For secondary deformities of cleft lip surgery to provide a clinical basis for selection.Methods:1,Use a ruler,triangle ruler,compass legs,vernier caliper measurement of unilateral complete cleft lip nose repair after form,compared with the normal of unilateral complete cleft lip nose to quantify morphological description and understanding of the extent of nasal deformities rules of unilateral complete cleft lip nasal deformities after repair of the second phase to provide the basis to quantify and standards.2,Patients with lip and nasal soft tissue measurements recorded.Through albirostris volumes,Vermilion edge,Cupid-bow,a high lip,nostril symmetry,alar dome appearance and the location of alar base 8 feet to assess the analysis parameters.3,Secondary cleft lip deformities are modified under the triangular flap to repair deformed lips,through the design of the upper lip were included in the next skin, muscle and mucosa,including the continuity of the triangular flap edge notch Vermilion,Vermilion edge alignment,the full restoration of Vermilion and symmetric. Bardach(including modified Bardach) incision two nasal deformity correction,as well as autologous cartilage on the nasal septum cartilage as a free access system to support both sides of the suture in the middle of lower nasal cartilage to further increase in the medial nasal columella feet higher to a new location to enhance the degree of tip penetration.Results:1,Millard repair in patients with normal nasal morphology group,patients with nasal tip - nose at the end of the distance smaller than normal;affected nostril diameter greater than the normal control group,their health,comparing the affected nostril diameter,significantly affected large in the contralateral;nasal columella is too short, this may be the application of the law Millard design flaws,we believe that the simple method of application the first time Millard cleft lip repair,after the nose is very difficult to achieve complete symmetry,the general need to visit Rhinoplasty 2.2,46 cases of clinical patients with lip nasal preoperative measurement and assessment of soft tissue,white lips,lips,labial arch,labial high nostril symmetry, alar dome appearance and the location of alar base 8 feet to assess the parameters of analysis,in which arch lip deformity incidence of 63%,nostril asymmetry 67% incidence of deformity,alar dome the appearance of inconsistency 89%incidence of malformations,as well as the nose-based incidence of foot deformities in 57%. 3,Based on the above parameters of the assessment results to the choice of appropriate methods of repair.In this study,the authors modified triangular flap repair of Vermilion,Bardach(or modified Bardach) incision repair of nasal deformities,as well as the extension of autologous septal cartilage nasal columella,nasal tip shape remodeling.The results showed that:lip,nose deformity has been corrected,the appearance of good.Non-surgical transplantation of autologous cartilage necrosis, complications such as wound infection occurred.Some patients were followed up for six months,the recent good results.Conclusions:Application of a simple method to repair cleft lip deformity first,after the nose is very difficult to achieve lip symmetry.Repair of two patients with preoperative nasal labial soft tissue measurement and evaluation is necessary,this will clinicians in the choice of surgical methods to provide a lot of help.The subject of the integrated approach used in the relevant parameters for the assessment of patients after surgery. The results show that for over 16 years of age in moderate and severe nasal deformity in patients with secondary lip.