Clinical analysis of nasal floor reconstruction by oral mucosal flap in 16 patients with non-syndromic unilateral complete cleft lip

doi:10.19438/j.cjoms.2018.05.008

Abstract

Abstract: PURPOSE: To explore the effect of applying oral mucosal flap to repair nasal floor of patients with non-syndromic unilateral complete cleft lip in one-stage operation. METHODS: Sixteen patients with unilateral complete cleft lip treated at School of Stomatology, Medical College of Qingdao University from September 2014 to September 2016 were retrospectively analyzed. Their nasal floor was repaired with oral mucosal flap. Photographs were taken before repair, 1 week and 1 year after surgery. The symmetry ratio of nasal floor and alar shape were calculated to analyze the clinical effect. SPSS 19.0 software package was used for statistical analysis. RESULTS: There was no oral-nasal fistulas(ONFs) and nasal floor notches in 16 cases. The nasal wing collapse was improved obviously. One year after operation, the symmetrical ratio of nasal floor width was 0.79±0.15, and the ratio of nostril width symmetry was 0.856±0.17, nostril height symmetry was 1.44±0.17, symmetrical ratio of nasal column was 1.62±0.48. There was significant difference before and after operation. CONCLUSIONS: Nasal floor repair in children with non-syndromic unilateral complete cleft lip with oral mucosal flap in one-stage operation can not only be beneficial to reduce the incidence of oral and nasal fistulas, but also help to close the fissure of nasal floor, restore the shape of nasal floor and properly correct nasal deformity.

Key words: Unilateral complete cleft lip, Nasal floor repair, Oral mucosal flap, One-stage operation

CLC Number:

R782.2.1

LI Yi-ying, YANG Xue-cai, HOU Zhi-jun, HU Ning-ning, WANG Jun-wei, CHU Xiao-yi, XIN Jun-tong. Clinical analysis of nasal floor reconstruction by oral mucosal flap in 16 patients with non-syndromic unilateral complete cleft lip[J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(5): 425-430.

References

[1] 郭胜胜, 章根训, 王杨洋, 等. 小泛素化修饰基因-1多态性与非综合征型唇腭裂的相关性研究[J]. 华西口腔医学杂志, 2012, 30(1): 97-102.
[2] 邓永强, 郑苍尚, 梁志刚. 单侧完全性唇裂术后鼻畸形整复术的临床分析[J]. 口腔医学研究, 2007, 23(3): 321-323.
[3] Chang L, Wang J, Yu L, et al.Closure of nasal floor by mucosal flaps on the upper lip margin in wide unilateral complete cleft lip[J]. J Craniofac Surg, 2012, 23(3): 866-868.
[4] 石冰,尹恒. 改进腭裂术后腭瘘发生率的表述与统计方法的建议[J]. 中华口腔医学杂志, 2013, 48(8): 499-501.
[5] 欧阳忠飞,张军,王翼,等. 侧唇黏膜瓣在Ⅲ度唇裂手术鼻底重建中的应用[J]. 中国医学创新, 2012, 9(27): 13-14.
[6] Farkas LG, Posnick JC.Growth and development of regional units in the head and face based on anthropometric measurements[J]. Cleft Palate Craniofac J, 1992, 29(4): 301-302.
[7] He X, Shi B, Jiang S, et al.110 infants with unrepaired unilateral cleft lip: An anthropometric analysis of the lip and nasal deformities[J]. Int J Oral Maxillofac Surg, 2010, 39(9): 847-852.
[8] Masuoka H, Kawai K, Morimoto N, et al.Open rhinoplasty using conchal cartilage during childhood to correct unilateral cleft-lip nasal deformities[J]. J Plast Reconstr Aesthet Surg, 2012, 65(7): 857-863.
[9] 张睿,郑谦,石冰,等.唇裂术后鼻部对称性的变化及其影响因素[J]. 华西口腔医学杂志, 2011, 29(1): 31-35.
[10] Beidas OE, Thompson DM, ElAC. Anthropometric effect of mucoperiosteal nostril floor reconstruction in complete cleft lip[J]. J Craniofac Surg, 2016, 27(1): 19-26.
[11] Millard DR Jr, Latham RA.Improved primary surgical and dental treatment of clefts[J]. Plast Reconstr Surg, 1990, 86(5): 856-871.
[12] Mulliken JB. Primary repair of bilateral cleft lip and nasal deformity [J]. Plast Reconstr Surg, 2001, 108(1): 181-194, 195-196.
[13] 肖苒, 徐慧芬, 石冰. 早期剥离术对鼻翼软骨生长发育影响的动物实验研究[J]. 华西口腔医学杂志, 1998, 5(4):305-307.
[14] Ruiz-Escolano MG, Martinez-Plaza A, Fernandez-Valades R, et al.Nasoalveolar molding therapy for the treatment of unilateral cleft lip and palate improves nasal symmetry and maxillary alveolar dimensions[J]. J Craniofac Surg, 2016, 27(8): 1978-1982.
[15] 梁志刚, 陈国鼎, 郑苍尚, 等. 鼻牙槽塑形对单侧完全性唇腭裂患儿术后鼻外形的影响[J]. 中国口腔颌面外科杂志, 2008, 6(3): 178-181.
[16] Randall P.Cleft lip[J]. Clin Plast Surg, 1975, 2(2): 215-233.
[17] 潘葵, 陈兵. 利用鼻底双旋转皮瓣修复单侧唇裂继发鼻底畸形[J]. 中国美容医学, 2012, 21(6): 915-916.
[18] 肖文芝, 陈涌, 刘华, 等. 下鼻甲黏骨膜瓣在完全性唇裂鼻底修复中的应用体会[J].中国美容医学, 2013, 22(8): 820-823.
[19] Sykes JM, Tollefson TT.Management of the cleft lip deformity[J]. Facial Plast Surg Clin North Am, 2005, 13(1): 157-167.
[20] 周炼, 石钿印, 余立江, 等. 单侧完全性唇裂一期修复中前鼻底重建技术改进[J]. 中国美容医学, 2016, 25(5): 35-38.
[21] Chang CS, Por YC, Liou EJ, et al.Long-term comparison of four techniques for obtaining nasal symmetry in unilateral complete cleft lip patients: a single surgeon's experience[J]. Plast Reconstr Surg, 2010, 126(4): 1276-1284.