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Objective To evaluate the clinical efficacy of triangle flap from the nasal vestibule on correcting the minor form unilateral incomplete cleft lip.Methods 72 patients with the minor-form unilateral incomplete cleft lip were invloved in this study.Based on different surgical procedures,all the patients were divided into two groups:36 patients were treated with harvesting a triangle flap from the nasal vestibule,rotating,increasing lip height;other 36 patients were treated with Millard method as control group.The positive photographs of two groups of patients were taken one year after surgery.Lip height,lip width,nostril width,nostril circumference and visible scar area were measured and compared statistically.Results Good rate of the group of the triangle flap from nasal vestibule was 91.6％ (33/36),but that of the group of Millard method was 72.2％ (29/36) (P＜0.05).The ratios of unaffected to affected sides of lip height,nostril circumference and nasal width in the triangle flap from nasal vestibule were 1.077±0.015,1.083±0.005,and 1.083±0.005;those of other group of Millard method were 1.078±0.013,1.095±0.005 and 1.096±0.015,respectively,with no significant difference (P＞0.05).But there was significant difference in laberal scar between the group of the triangle flap from nasal vestibule (0.510±0.004) mm2 and the control group of Millard method (0.830±0.009) mm2 (P＜0.05).Conclusions The nasal vestibule triangle flap method can significantly decrease the visible scar on lip and achieve the same good result compared to traditional Millard method.
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Objective To explore the differences between normotrophic and hypertrophic scars of lip after the surgical repair of the unilateral complete cleft lip in density of microvessels and the pattern of angiogenesis.Methods Hypertrophic scars (n=11) and normotrophic scars (n=20) were collected after correction of deformity of the unilateral complete cleft lip,and the tissues were stained with haematoxylin and eosin,and immunostained with anti-CD34 antibody.The structure of scar was observed and the microvessels were counted according to the CD34 expression.Using ImageJ software,the capillary density and length of the major and minor axes were measured,and the major:minor axes ratio was calculated.Results By statistical analysis of the capillary density,the length of the major and minor axes and the major:minor axes ratio were measured;we clarified that there were more capillaries in hypertrophic scars (87.91 ± 5.95)/mm2 than in normotrophic scars (49.84 ± 7.05)/mm2,(P＜0.01),and the length of the major and minor axes of hypertrophic scars (38.36± 26.36)and (17.33±10.45) μm were longer than the normotrophic scars (13.77±9.56)and (9.00± 5.14) μm,(P＜0.05.) The major:minor axes ratio of hypertrophic scars (2.85±0.57) was higher than the normotrophic scars (2.85 ± 0.57) (P＜0.01).Conclusions The significant increase in the density of microvessels and the variation in the pattern and morphology of angiogenesis are related to the formation and development of scar after operation of upper lip.
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Objective To explore the method to correct nasal deformity of the bilateral complete cleft lip and to eveluate the benefits of this teachnique.Methods Sixteen patients with the bilateral complete cleft lip were consecutively chosen to correct the nasal deformity of the bilateral complete cleft lip.We performed an open approach to facilitate alar cartilage manipulation while repairing the bilateral complete cleft lip,and elevated the prolabial flap for reconstructing the continuity of orbicularis oris musele artery by anatomizing and protecting the prolabial-columellar artery.Nasal columella length and wideth,nasal wideth,ratio of nasal length to face length,ratio of nasal wideth to the distence of nasolabial angle were analyzed after a minimum of 10 years after surgery.These were compared with those in a normal,age-matched control group.Results Appreance of nose and lip of 16 patients after surgery were satisfying and long-term results were good by following-up for 10 years.Columellar length and ratio of nasal length to face length were not significantly different from that of the control group.Nasal wideth,columella wideth,tip projetion and nasolabial angle were all significantly greater in the cleft group than the normal (P＜0.05).Conclusions Prolabial flap manipulation is a safe approach by using anatomizing the columellar-labial artery.This teachnique is effective and yields good long-term results.
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Objective To develop a new method for correction of the deformity of the complete bilateral cleft lip with short pre-lip. Methods Two specimens with the complete bilateral cleft lip was chosen to investigate the arterial supply to the pre-lip. The arteries were observed by radiography when the specimen was infused with lead oxide. 16 patients with the complete bilateral cleft lip and shortage in the length of pre-lip were enrolled in this study. Taking advantage of the unique character of arterial supply of complete bilateral cleft lip, those with short pre-lip were corrected. Photos of them were taken when preand post-operation for further measurement. And more than 1 year following-up was conducted to judge if the results were good enough or not. 30 babies were chosen as a control group to confirm the results of surgury objectively. Results Post nasal septal arteries were found to supply the pre-lip of the bilateral complete cleft lip. Appearance of 16 patients was good after surgery or 1 years later. There was no statistical significant difference between the patients and control group in the measurement data but nasal-lip angle. Conclusion It is an effective way to correct deformity of the bilateral cleft lip with short pre-lip by taking advantage of post nasal septal arterie's flap.