When will the rabbit lip children (lip cracks) do surgery?What are the requirements for repair?
Rabbit lips are actually the common name of lip cracks. Clearing lip and palate is the most common congenital deformity of the maxillofacia. You can see the defects of the lip and palate at birth, and affect the physiological functions such as sucking, diet, pronunciation, swallowing, and breathing. The degree of deformity and dysfunction is closely related to the size of the crack.
Lip cracks can be divided into::
① Unilateral: complete, incomplete.
② Bilateral: complete, incomplete, mixed (complete on one side, incomplete side).
③ Middle cracks: It can be accompanied or not accompanied by nasal cracks.
According to the degree of cracking, lip cracks can be divided into three degrees: Ⅰ degree limit to lip red cracks; Ⅱ degree upper lip part is split, but not the bottom of the nose; Ⅲ degree is the upper lip and nose bottom. Ⅰ degree and Ⅱ degree lip cracks are also called incomplete lip cracks: III degree is complete lip cracks.
The cleft palate can be divided into:
① soft shirt or hanging Yongyong.
② Unilateral incomplete cracking.
③ Unilaterally cleft palate.
④ A completely cleft palate on both sides.
Clearing lip and palate is congenital malformations. If the child can receive plastic surgery treatment before the character and psychological development are mature, and improve the appearance, the physical and mental development of the child will be no different from healthy children.
The repair time of lip fissure is mainly based on the whole body and deformity of the child.
It is generally believed that children with unilateral lip cracks with good whole body condition will be repaired about 3 months after birth, and it is more appropriate to repair bilateral lip cracks in 6 to 12 months. The techniques of surgicals, the methods of surgery, and the level of anesthesia and the level of nursing are 2 or 3 months in advance when they are relatively good. For example, the venoma regulation, because the surgery time is relatively long and the bleeding is more, the age of surgery can be delayed appropriately.
Lip cracks can accumulate skin, muscles, mucous membranes, bones and cartilage. Such complicated malformations cannot be corrected through an operation in infant. Such as some malformations, tiny errors during surgery, surgical scars, etc., will gradually become obvious as the children grow up, so the second operation is generally arranged before school age.
The third surgery generally needs to be adults. At this time, the tissue structure of the lips and nose is basically developed. After surgery, it will not deform and displace it, which can achieve the ideal results.
The best time to repair cleft palate is currently controversial. Most scholars advocate 18 months after birth and completed before the age of 7.
It is usually suitable for about 2 to 4 years. The age of 2 is a period of speaking. If the palate can be repaired before, so that the palate can play normal functions early. Children can learn more naturally, establish normal pronunciation habits, and the soft palate muscles can also get better development. , Rebuild the well -closed palate pharyngeal, thereby obtaining the ideal treatment effect.
From the perspective of pronunciation, it should be performed early, but premature surgery may affect the normal development of the upper jaw. Therefore, there are currently two different opinions of early and advanced surgery at home and abroad.
Clinically, it should be determined in conjunction with the whole body condition, cleft palate, and technical conditions of the children.
What are the basic requirements of lip fissure repair surgery?
The basic requirement is to restore the normal shape and function of the lips and nose.
Normal lips and noses have the following characteristics: the nostrils on both sides are large, the tip of the nose and nose is centered in the middle, the nose is not collapsed, the upper lip is equal, symmetrical, the red lips are full of lip bead slightly, the lips and red margin are in bowls and the back of the back shape.
Through surgery, the abnormal attached lip muscles are restored to normal positions and have normal connections, so that it has a good form not only when the lip is still, but also has normal lip muscle function activity during lip function activity. Essence The above anatomical characteristics and functional requirements can be used as the basis for lip fissure repair surgery.
For details, the recovery of the nose should be reached:
Make the bridge of the nose in the middle, and the nasal septum is not deformed (unilateral lip cracks are often accompanied by nasal septum bias, so the recovery surgery should include the correction of the nasal septum):
The position of the affected side of the nose (including the horizontal position in the upper and lower directions and the vertical position of the front and rear directions) should be symmetrical with the healthy side:
The nasal pillar should have a certain length and in the middle position:
The nose on both sides is symmetrical. The nostril shape of the affected side should be symmetrical with the healthy side, and the affected side nasal ventilation should be normal.
The recovery effect of the lips should be achieved:
The height of the lips on both sides of the upper lip (bilateral lip cracks should reach the red lip margin 1 ~ 2 mm when the upper lip is relaxed);
The width ratio of the upper and lower lips is harmonious and the width of the lips meets the aesthetic principle of the facial “three courts and five eyes”;
The natural anatomical structure of the upper lip such as the lip people, the peak of the lip peak, and the nest of the people should be reserved and reconstructed to the greatest extent;
The morphology of the lip peaks on both sides;
The angle distance between the lip peak mouth on both sides should be equal and symmetrical;
1/3 of the upper lip and 1/3 lip swim departure should have natural relaxation and slight external warp;
The upper nose and lip angle should be normal;
Red lips should reach the complete state in four arc shapes such as the upper edge, the front edge of the lower edge, and the upper and lower edges;
Lip nodules (lip beads) are saved or rebuilt;
After the upper lip tissue is surgery, there should be soft and no visible hard scars.
According to the above requirements, unilateral lip cracks are easy to achieve the purpose of repair than bilateral lip cracks, mainly because bilateral lip cracks are not like unilateral lip cracks on the healthy side of the healthy side, and the amount of lip tissue is richer than bilateral lip cracks. The natural anatomical signs of bilateral lip lips are completely lost, and related deformities (such as nasal deformities) are also very serious, and some are not completely resolved by surgery reconstruction. Therefore, the recovery effect of bilateral lip cracks is still a problem that has not yet been solved.
Reference article:
Wang Wei. Plastic Surgery Surgery. Hangzhou: Zhejiang Science and Technology Edition .1999
Li Hongyi, Kuang Hai, Wang Xiaomeng, etc., etc., unilateral complete lip fissure patients with three -dimensional measurement analysis of alveolarism after the treatment of alveolar processes before surgery [J]. West China Stomatology Magazine, 2016, 34 (4): 375-380. Doi: 10.7518/HXKQ.2016.04.011. Wu Yilai. Three -dimensional measurement and individualization of the nose -wing base after lip fissure [D]. Shanghai: Shanghai Jiaotong University, 2011. 2011.
Zhang Lei. Unilateral lip lobe subtromascs followed the softening of the deformed nose, the upper jaw measurement and deformity classification [D]. Liaoning: China Medical University, 2009. Doi: 10.7666/D.Y1488389.
Han Xinying. Symptoms of the nasal maxillary complex in patients with a complete lip and palate patient for the tooth period [d]. Shandong: Qingdao University, 2017.
Luo Xiaohua, Zhang Wenwen. Research progress of unilateral lip nose deformity [J]. China Medical Beauty, 2019, 9 (3): 120-126. Doi: 10.19593/J.ISSN.2095-0721.2019.03.032.
