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近15～20年来,唇裂鼻畸形的初期整复愈来愈受到临床医生的重视,许多术式不断得到创新和发展。本文作者在临床工作中发现唇裂患者的患侧鼻翼内侧皮肤组织常有条索状组织,从梨状孔垂直向上到鼻翼软骨衬里,导致了患侧鼻翼软骨的移位畸形。所以作者1994～1997年间,对88例(其中一期修复42例,平均年龄12个月;二期修复46冽,平均年龄16岁)唇裂鼻畸形患者采用了患侧鼻翼内三角皮瓣“V-Y”推进法矫正鼻翼畸形。其手术方法为用15号刀片沿患侧鼻穹隆的条索状组织作切口,然后在鼻软骨的浅面向上达鼻翼缘。沿同一始点,在条索状组织的另一边作切口,掀起两切口间皮肤,形成一个以鼻翼缘为蒂的“V”形三角瓣,然后在切口两侧下行潜行分离,使鼻翼软骨和鼻腔衬里完全游离,在保证患侧穹隆与健侧穹隆同一水平和两侧鼻缘对称的条件下将三角瓣在无张力情况下就位后与创缘对位缝合,遗留创面利用“V-Y'’法直接关闭(见图1)。纱布卷填塞鼻腔。对于某些二期唇裂鼻畸形病
In the past 15 to 20 years, the initial healing of cleft lip nasal deformity has been paid more and more attention by clinicians, and many surgical procedures have been continuously innovated and developed. In clinical work, the authors found that the inner side of the alar inner skin of the patients with cleft lip often has cord-like tissue, which goes up vertically from the piriform hole to the alar cartilage lining, resulting in the displacement deformity of the alar cartilage on the affected side. Therefore, during the period of 1994-1997, 88 patients (42 of them were repaired in the first phase, with an average age of 12 months; the second was repaired with a mean of 46 years and the mean age was 16 years old) were treated with the triangular flaps “VY Promote the law to correct nasal deformity. The surgical approach is to use a 15-blade along the affected side of the nasal ribbon cord tissue incision, and then reach the nasal cartilage in the shallow up to the nasal flange. Along the same starting point, an incision is made on the other side of the cord-like tissue to lift the skin between the two incisions to form a ”V“ -shaped triangular flap pedicled on the nose and slipping off on both sides of the incision so that the alar cartilage and nasal cavity Lining completely free, in ensuring the ipsilateral vault and the contralateral vault on the same level and the bilateral nasal symmetry under the conditions of the triangular flap in place without tension and the origin of the right seam, the residual wound using ”V-Y ' 'Law directly off (see Figure 1) gauze roll stuffed nasal cavity. For some of the second cleft lip nasal deformities