唇裂

Objective To investigate the effect of Abbe flap on reconstruction of tightness deformity of upper lip after unilateral cheilorrhaphy.

目的：探讨采用Abbe瓣修复单侧唇裂术后上唇过紧畸形的手术方法和效果。

After the biomechanical finite element analysis for the three-dimensional reconstruction model, we find the structure of the deformed nose showes the following characteristics: 1, Nasal septum, nasal columella, lateral feet of nasal alar, lateral nasal dorsum are stress concentrated regions, that is the key mechanical positions of deformed nose; 2, Under the static state, nasal deformation has a very small value of stress distribution, under displacement load status, the deformed nasal has a large value of the stress distribution; 3, Ipsilateral nasal columella are the the key mechanical parts of deformed nasal rectify. And lateral nasal alar is also the most stress concentrated areas.

对于重建后的单侧唇裂鼻畸形鼻部模型进行有限元生物力学研究，发现畸形鼻的力学结构呈现以下特点：1、鼻中隔、鼻小柱、鼻翼外侧脚、鼻背外侧是单侧唇裂鼻畸形应力分布的集中部位，也就是畸形鼻部的力学关键部位；2、在静态状态下，畸形鼻部拥有的应力分布值很小，在位移载荷状态下，形变后的畸形鼻部拥有的较大的应力分布值；3、单侧唇裂鼻畸形整复中，鼻小柱患侧部是畸形整复的力学关键部位，其次就是患侧鼻翼部。

It suggested that under static status, the nasal septum, nasal columella and the lateral feet of nasal alar were the most concentrated areas of stress distribution. They are key mechanical parts of deformed nasal.3.2 Nasal displacement load analysis of patients with unilateral cleft lip and nasal alar collapse Deformed nasal displacement load three-dimensional finite element analysis showed that if the ipsilateral and contralateral nasal parts obtain similar geometry, the positions around nasal columella in ipsilateral nostril were the most stress concentrated region, next parts were the nasal septum and the lateral nasal alar.

提示静态状态下，鼻中隔、鼻小柱和两侧鼻翼外侧角是应力分布最集中部位，也是畸形鼻部的关键力学部位。3.2单侧唇裂鼻翼塌陷畸形患者的鼻部位移载荷形变后力学分析单侧唇裂鼻畸形患者的位移载荷三维有限元分析表明，畸形鼻部的患侧要获得和健侧近似的几何形态，其患侧鼻孔近鼻小柱周围应力分布最为集中，其次为鼻中隔和患侧鼻翼外方。

According to the cleft position, it can be classified as single harelip and bilateral harelip. Sometimes, there is a cleft on both upperlip and underlip, but this case is rare.

根据裂隙部位又可分为单侧唇裂和双侧唇裂，有时也可见上唇或下唇中裂，但较为少见。

Methods We used the amended Millard's method and simultaneously united the edge mucosa flap on 21 patients to repair the unilateral complete cleft lip and to obturate the oral-nasal fistula.

应用改良Millard法与裂隙缘粘膜瓣联合应用修复单侧重度完全性唇裂，笔者自2000年始应用此法对单侧完全性重度唇裂的鼻槛修复及口、鼻瘘口封闭、鼻堤重建效果满意。21例患者创口均Ⅰ期愈合。

The result shows that there are not only appearance malformations, but also muscle fiber ultra structure variations for BCL. No matter complete or incomplete the BCL is, the good prolabium muscles can only be obtained through the functional muscle repair.

双侧唇裂既有外形的畸形，也有肌纤维形态及超微结构的变异，无论完全性或不完全性双侧唇裂都需行功能性恢复，才能获得良好的前唇部肌肉及功能。

Results It showed that the prolabium of complete BCL had no muscle, there were only weblike collagen fibers of bundles of them, capillaries, fats and fats and fiber－blasts. There were muscle fibers in prolabium and bridges of incomplete BCL,but ultra structure variations were found. The prolabium of complete BCL operated on with straight line suture method had muscle fibers proliferated from the lateral lips, but the fibers were sparse and also had ultra structure variations.

结果 发现完全性双侧唇裂的前唇部无肌纤维，双侧不完全性唇裂的前唇及桥部有少量肌纤维，但其超微结构有变异；用直线缝合法修复的完全性双侧唇裂的前唇部，有从侧唇增生的肌纤维，但稀少，超微结构亦有变异。

The anatomic and histological examination and comparison of the musculus depressor septi nasi were performed in 33 normal cadavers and 30 patients with unilateral cleft lip undergoing the operation for secondary nasal deformities.

我们在唇裂与正常鼻肌肉组织的解剖组织学比较观察中发现，单侧完全性唇裂患侧降鼻中隔肌缺损，有助于正确理解唇裂鼻小柱和鼻中隔软骨尾缘的移位与畸形等特征性形态的形成。

Methods Millard of cleft lip repair was used with correction of nasal deformities at the same time, in which the displaced alar cartilage and the deviated septum were replaced to their normal anatomical position.

采用Millard唇裂修复法修复唇裂，同期矫正鼻畸形，使移位的鼻翼软骨、鼻中隔软骨复位，以恢复正常的解剖关系。

We obtained the nasal deformation with three-dimensional reconstruction images and adjusted to separate the images of nasal cartilage, defined the form and structure of nasal deformation. Then we measured 10 cases of adult cadavers nasal alar, lateral and septal cartilage through modern mechanical measuring instruments, to obtain the elastic modulus of above three part structure of nasal cartilage, then to obtain more accurate nasal cartilage elastic modulus data through statistical analysis. At the same time, according to the relevant literature, we obtained nasal soft tissue biomechanical properties, mainly were elastic modulus and Poisson\'s ratio. Finally we established three-dimensional finite element analysis model of unilateral cleft lip nasal deformation, defined the model\'s constraint conditions and carried out biomechanical measurement and analysis of unilateral cleft lip nasal deformation.

将唇裂鼻畸形患者鼻部进行三维重建并调校，分离出外鼻软骨的影像，并对鼻部组织进行分层和重建，确定畸形鼻的形态和组织结构；通过现代力学测量仪器，对10例成人尸体鼻部的大翼、侧鼻和中隔软骨进行弹性模量的测量，获得上述三部分鼻部软骨结构的弹性模量数据，并通过统计学分析来获得较为准确的鼻部软骨结构的弹性模量数据，同时查阅相关文献，得到鼻部软组织的相关生物力学性质，主要为弹性模量和泊松比；建立单侧唇裂鼻畸形的畸形鼻部三维有限元分析模型，确定有限元分析的边界条件等，进行单侧唇裂鼻畸形的鼻部生物力学的测量和分析。

I am accused of being overreligious," she said in her quiet, frank manner,"but that does not prevent me thinking the children very cruel who obstinately commit such suicide.""

客人们在卡罗利娜·埃凯家里，举止就文雅一些，因为卡罗利娜的母亲治家很严厉。

Designed by French fashion house Herm è s, this elegant uniform was manufactured in our home, Hong Kong, and was the first without a hat.

由著名品牌 Herm è s 设计，这件高贵的制服是香港本土制造，是我们第一套不配帽子的制服。