APPLICATION OF MORTISE-TENON ORBICULARIS ORIS MUSCLE FLAP FOR PHILTRUM COLUMN DEFORMITY SECONDARY TO UNILATERAL CLEFT LIP REPAIR_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHU Gefei , MAI hui.

Department of Plastic Surgery, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning Guangxi, 530021, P.R.China. Corresponding author: ZHU Gefei, E-mail: zhugefei@21cn.com;

Corresponding author：

Keywords：

Cleft lip Secondary deformity; Orbicularis oris muscle flap; Philtrum column deformity

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ObjectiveTo investigate the effectiveness of the mortise-tenon orbicularis oris muscle flap for philtrum column deformity secondary to the unilateral cleft lip repair. MethodsBetween January 2009 and August 2011, 43 patients with philtrum column deformity secondary to unilateral cleft lip repair were treated. There were 23 males and 20 females with an average age of 23.6 years (range, 18-31 years). The left philtrum column was involved in 26 cases, and the right side in 17 cases. Cleft lip was repaired with Millard I in 15 cases and with Millard II in 28 cases. The time between cleft lip repair and philtrum column deformity correction was 15-30 years (mean, 21.7 years). The bilateral double orbicularis oris muscle flap was obtained, and then was divided horizontally into two layers. The overlapping suture of the bilateral lower muscle flap was perfomed, and the upper layer muscle was designed into the mortise-tenon orbicularis oris muscle flap and was sutured with contralateral skin. ResultsAll incisions healed by first intention. Forty cases were followed up 13.4 months on average (range, 6-34 months). The patients achieved satisfactory effects in bilateral symmetry philtrum column and normal concave shape. At 6 months after operation, significant improvement was observed in 38 cases and no obvious improvement in 2 cases. ConclusionThe mortise-tenon orbicularis oris muscle flap is a simple operation and can obtain good results in the appearance and function of the upper lip in the correction of philtrum column deformities secondary to the unilateral cleft lip repair.

Citation： ZHU Gefei,MAI hui.. APPLICATION OF MORTISE-TENON ORBICULARIS ORIS MUSCLE FLAP FOR PHILTRUM COLUMN DEFORMITY SECONDARY TO UNILATERAL CLEFT LIP REPAIR. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1081-1083. doi: Copy

1.	Garcia de Mitchell CA, Pessa JE, Schaverien MV, et al. The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg, 2008, 122(6): 1756-1760.
2.	Cakir B, Gideroglu K, Akan M, et al. Jack-like eversion by splitting the orbicularis oris muscle for reconstruction of the philtral column in secondary cleft lip. Scand J Plast Reconstr Surg Hand Surg, 2009, 43(1): 8-15.
3.	张彬, 李克义, 牛怀恩, 等. 改良皮肤切口及口轮匝肌解剖学重建在先天性双侧唇裂修复术中的应用. 山东医药, 2008, 48(8): 27-29.
4.	王佳崎, 赵敏, 熊斌, 等. 上唇肌瓣镶嵌三层固定缝合修复单侧唇裂人中嵴. 中华医学美容杂志, 2000, 6(5): 267-268.
5.	Kishi N, Tanaka S, Iida S, et al. The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg, 2012, 40(3): 215-222.
6.	Housman TS, Berg D, Most SP, et al. Repair of the philtrum: an illustrative case series. J Cutan Med Surg, 2008, 12(6): 288-294.
7.	Khandekar BV, Srinivasan S, Mokal NJ. Median cleft lip: A new method of surgical repair. Indian J Plast Surg, 2010, 43(1): 111-113.
8.	Meyer E, Seyfer A. Cleft lip repair: technical refinements for the wide cleft. Craniomaxillofac Trauma Reconstr, 2010, 3(2): 81-86.
9.	Ray TL, Chow S, Lee PK. Myocutaneous island pedicle “sling” flap for correction of central upper cutaneous (philtral) lip defects. Dermatol Surg, 2010, 36(5): 671-674.
10.	Lim AA, Allam KA, Taneja R, et al. Construction of the philtral column using palmaris longus tendon. Plast Reconstr Surg, 2012, 129(2): 374e-375e.
11.	Cho BC, Baik BS. Formation of philtral column using vertical interdigitation of orbicularis oris muscle flaps in secondary cleft lip. Plast Reconstr Surg, 2000, 106(5): 980-986.
12.	孙家明, 李薇薇, 乔群. 口轮匝肌垂直交叉法在继发唇裂人中嵴重建中的应用. 中华医学美学美容杂志, 2007, 13(3): 179-180.
13.	翦新春, Miqdadi MMA, 陈顺金, 等. 单侧唇裂继发畸形修复中口轮匝肌的重建. 中华医学美学美容杂志, 2007, 13(4): 207-210.
14.	张奎启, 韩辉, 林丽, 等. 口轮匝肌和人中形态的解剖学研究. 中华口腔医学杂志, 1990, 25(6): 353-354.
15.	Mishimagi T. Three-dimensional analysis of the morphology of philtrum and philtral dimple of unilateral cleft lip/cleft lip and palate patients before and after secondary cleft lip and nose repair. Kokubyo Gakkai Zasshi, 2010, 77(2): 128-139.
16.	Kishi N, Tanaka S, Iida S, et al. Comprehensive evaluation of three-dimensional philtral morphology. Craniofac Surg, 2011, 22(5): 1606-1611.

1. Garcia de Mitchell CA, Pessa JE, Schaverien MV, et al. The philtrum: anatomical observations from a new perspective. Plast Reconstr Surg, 2008, 122(6): 1756-1760.
2. Cakir B, Gideroglu K, Akan M, et al. Jack-like eversion by splitting the orbicularis oris muscle for reconstruction of the philtral column in secondary cleft lip. Scand J Plast Reconstr Surg Hand Surg, 2009, 43(1): 8-15.
3. 张彬, 李克义, 牛怀恩, 等. 改良皮肤切口及口轮匝肌解剖学重建在先天性双侧唇裂修复术中的应用. 山东医药, 2008, 48(8): 27-29.
4. 王佳崎, 赵敏, 熊斌, 等. 上唇肌瓣镶嵌三层固定缝合修复单侧唇裂人中嵴. 中华医学美容杂志, 2000, 6(5): 267-268.
5. Kishi N, Tanaka S, Iida S, et al. The morphological features and developmental changes of the philtral dimple: a guide to surgical intervention in cases of cleft lip. J Craniomaxillofac Surg, 2012, 40(3): 215-222.
6. Housman TS, Berg D, Most SP, et al. Repair of the philtrum: an illustrative case series. J Cutan Med Surg, 2008, 12(6): 288-294.
7. Khandekar BV, Srinivasan S, Mokal NJ. Median cleft lip: A new method of surgical repair. Indian J Plast Surg, 2010, 43(1): 111-113.
8. Meyer E, Seyfer A. Cleft lip repair: technical refinements for the wide cleft. Craniomaxillofac Trauma Reconstr, 2010, 3(2): 81-86.
9. Ray TL, Chow S, Lee PK. Myocutaneous island pedicle “sling” flap for correction of central upper cutaneous (philtral) lip defects. Dermatol Surg, 2010, 36(5): 671-674.
10. Lim AA, Allam KA, Taneja R, et al. Construction of the philtral column using palmaris longus tendon. Plast Reconstr Surg, 2012, 129(2): 374e-375e.
11. Cho BC, Baik BS. Formation of philtral column using vertical interdigitation of orbicularis oris muscle flaps in secondary cleft lip. Plast Reconstr Surg, 2000, 106(5): 980-986.
12. 孙家明, 李薇薇, 乔群. 口轮匝肌垂直交叉法在继发唇裂人中嵴重建中的应用. 中华医学美学美容杂志, 2007, 13(3): 179-180.
13. 翦新春, Miqdadi MMA, 陈顺金, 等. 单侧唇裂继发畸形修复中口轮匝肌的重建. 中华医学美学美容杂志, 2007, 13(4): 207-210.
14. 张奎启, 韩辉, 林丽, 等. 口轮匝肌和人中形态的解剖学研究. 中华口腔医学杂志, 1990, 25(6): 353-354.
15. Mishimagi T. Three-dimensional analysis of the morphology of philtrum and philtral dimple of unilateral cleft lip/cleft lip and palate patients before and after secondary cleft lip and nose repair. Kokubyo Gakkai Zasshi, 2010, 77(2): 128-139.
16. Kishi N, Tanaka S, Iida S, et al. Comprehensive evaluation of three-dimensional philtral morphology. Craniofac Surg, 2011, 22(5): 1606-1611.

Chinese Journal of Reparative and Reconstructive Surgery

APPLICATION OF MORTISE-TENON ORBICULARIS ORIS MUSCLE FLAP FOR PHILTRUM COLUMN DEFORMITY SECONDARY TO UNILATERAL CLEFT LIP REPAIR

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