Objective: To discuss the clinical application and effectiveness of autologous costal cartilage transplantation in the repair of upper lip depression in the secondary repair of cleft lip.
Methods: The clinical data of 10 patients of secondary repair of upper lip depression with cleft lip by autologous costal cartilage transplantation between January 2017 and January 2019 were retrospectively analysed. There were 7 males and 3 females with an average age of 24 years (range, 18-33 years). There were 8 cases of bilateral lip fissure and 2 cases of unilateral lip fissure. All of them underwent early lip repair at the age of 2-3 years old. The change of the profile of the soft tissue profile of the upper lip of the patient was quantitatively analyzed before operation and at immediate after operation, including the soft tissue facial angle (G-Sn-Pg'), the nasolabial angle (Cm-Sn-UL), the mentolabial angle (UL-LL-Pg'), the distance between the most salient point of the upper lip to the aesthetic plane (UL-E), the highest point of the frontal part, the projection distance of the most salient point of the upper lip on the plane of the orbital ear (G-UL), and the upper lip protrusion (ULP).
Results: One case had incision infection and healed after dressing change, and in the other 9 patients, the incisions healed by first intention, and no acute infection and other complications occurred. The appearance of the lateral morphology of the upper lip at immediate after operation was significantly improved when compared with that before operation. The value of UL-LL-Pg', UL-E, G-UL, and ULP were significantly increased and G-Sn-Pg' was significantly decreased when compared with preoperative ones ( P<0.05). There was no significant difference in Cm-Sn-UL between pre- and post-operation ( t=0.821, P=0.433). All the 10 patients were followed up 6-24 months, with an average of 15 months. During the follow-up, the soft tissue morphology of the upper lip was good. No long-term complications such as cartilage absorption and cartilage displacement were found.
Conclusion: Autologous costal cartilage transplantation is a safe and effective treatment for upper lip depression in the secondary repair of cleft lip.
目的: 探讨自体肋软骨移植在唇裂二期修复上唇凹陷中的临床应用效果。.
方法: 回顾分析 2017 年 1 月—2019 年 1 月采用自体肋软骨移植修复的 10 例唇裂二期上唇凹陷患者临床资料。其中男 7 例，女 3 例；年龄 18～33 岁，平均 24 岁。双侧唇裂 8 例，单侧唇裂 2 例，均于 2～3 岁行早期唇裂修补术。术前及术后即刻采用定位侧位照片测量分析法，对患者上唇软组织侧貌变化进行定量分析，测量指标包括：软组织面型角（G-Sn-Pg’），鼻唇角（Cm-Sn-UL），颏唇角（UL-LL-Pg’），上唇最突点到审美平面的距离（UL-E），额部最高点、上唇最突点在眶耳平面上的投影距离（G-UL），上唇突度（ULP）。.
结果: 术后 1 例出现切口感染，经换药处理后愈合；余 9 例患者术后切口均Ⅰ期愈合，未出现急性期感染等并发症。术后即刻患者上唇凹陷侧貌较术前明显改善，UL-LL-Pg’、UL-E、G-UL、ULP 均较术前显著增加，G-Sn-Pg’ 较术前显著减小，差异均有统计学意义（ P<0.05）；Cm-Sn-UL 手术前后比较差异无统计学意义（ t=0.821， P=0.433）。10 例患者均获随访，随访时间 6～24 个月，平均 15 个月。随访期间患者上唇软组织形态保持良好，无明显软骨吸收、软骨移位等远期并发症发生，外形轮廓中无明显软骨凸显。.
结论: 自体肋软骨移植修复唇裂二期上唇凹陷是一种安全有效的方法。.
Keywords: Autologous costal cartilage transplantation; the secondary repair of cleft lip; upper lip depression.