The Clinical Research Of Using Autologous Costal Cartilages To Repair The Secondary Cleft Lip Nose Deformity

[Objective]Cleft lip is a common congenital maxillofacial deformities, now more than3months to1year new born chose stage I prosthetics. The influence of various factors as stage I operation methods, timing of surgery, patients with deformity, abnormal local tissue development of postoperative infection and other postoperative secondary nasal lip deformity is often difficult to avoid, and to varying degrees. Mainly as a common deformity in patients with cleft lip secondary nasal lip:lips asymmetrical, vermilion border missing, obvious scar; vermilion notch, high and inadequate lip; health ipsilateral nostril shape, size and asymmetry; nasal basal growth wide, oval-shaped nostrils in the horizontal direction; ipsilateral nose based feet out down the stretch, the nose flat and collapse; deviation to the contralateral nasal septum of the tail and nose ridge; nasal tip asymmetry, lack of nasal floor, mouth and nose fistula. The deformity of each patient is different, the repair method and purpose. This study was designed to cleft lip secondary nasal deformity in patients with stage Ⅱ repair preoperative deformity parameters assessment to understand the degree of deformity and laws, from the anatomical relationship between the physiological function of autologous costal cartilage correction of cleft lip secondary nasal after deformities,and through the measurement to the overall assessment of the surgical treatment of the feasibility and efficacy of preoperative and postoperative.[Method]56patients after stage I cleft lip repair from March2010to October2011,with white lip,red lip, scar appearance, lip bow shape, high lip, nostril symmetry, nasal fornix symmetry of the alar base feet measurement, the measurement data obtained centralized aspects of the nose and lip deformity performance, in order to classify the deformity in patients with cleft lip secondary. The proposed method of autologous costal cartilage by the same surgeon, the surgical correction of cleft lip secondary nasal lip deformity in patients with postoperative outcome evaluation by measurement of the patients nose and lips. Out-patient review and follow-up observation of the combination of surgery long-term treatment effects to explore and evaluate the effect of secondary nasal deformity patients after application of autologous costal cartilage correction of cleft lip.[Result]Cleft lip secondary lip deformity location and surgical methods of lip deformities fall into three categories:1.Red Lip deformity;2. White lip deformity;3.upper lip too loose or too tight deformity. According to the clinical features of secondary nasal deformity, nasal deformity is divided into three categories:1.mild deformity:normal height and width of the upper lip, vermilion parts of deformity a little obvious, the performance for a mild groove-like depression, uneven lip and bow, lip beads missing, such as dry lips and the exposed area of asymmetry. The nose shape is normal compared with normal subjects. Columella centrally located or slightly oblique, length not less.For patients, mild deformity only need lip repair and nose do not need.2.Moderate deformity:normal upper lip width, but significantly less than the ipsilateral lip. Accompanied by the columella short, deflection, ipsilateral nose flat to collapse, alar base of the parts of the depression, the ipsilateral nostril compared with the contralateral nostril.3.severe deformity: the tight organization of the ipsilateral upper lip skin, lips obviously insufficient, lip width significantly narrower in the lower lip, accompanied with red lip deformity. Columella short, the shift to the contralateral, the health ipsilateral nose, nostrils obvious asymmetry, ipsilateral alar base of the collapse is obvious. For moderate and severe deformity patients, you need to nasal lip deformity restored. Before surgery,56patients, including the measurement of white lip,red lip,scar appearance, lip bow shape, lips and nostril symmetry, nasal fornix symmetry, nose footing symmetry.A total of52cases of severe deformity patients using autologous costal cartilage to correct cleft lip secondary nasal deformity, postoperative correction rate and the ratio of the judgment, found that patients with nasal appearance improved significantly, patients have satisfied surgery results.[Conclusion]Cleft lip secondary nasal deformity is an multifactor deformity, based on a new nasal bone trestle. Objective and comprehensive evaluation of the patient’s nose, and the ipsilateral alar cartilage anatomy reset, to strengthen the tip of the nose support force is the key of surgical treatment. Self rib cartilage materials convenient, bone mass rich, quality of a material is less fat, for severe cleft lip secondary nasal deformity patients can be satisfied with the clinical treatment effect,improve good nasal shape, especially the nasal tip shape and height.