隐性唇裂畸形机制的肌肉张力带解析

摘要

Due to insufficient understanding of the mechanism of the lesser-form cleft lip in clinical practice,the "muscle anatomical reduction" method,which is the general treatment option for the typical cleft lip,is also preferred for the treatment of lesser-form cleft lip,and the repair effect is often far from the patient's expectation.Based on the anatomical study and clinical observation of the lesser-form cleft lip in more than ten years,the author systematically describes the characteristics regarding the disarrangement of muscle and explains the confusing clinical features of the lesser-form cleft lip.In addition,the pathological mechanism of the lesser-form cleft lip is further classified,and the muscle biomechanical biomimetic repair technique of this defect-" Yin's nasolabial muscle frame" is proposed to guide clinical operations.This article preliminarily summarizes the author's new understanding of the lesser-form cleft lip in recent years.The nasolabial Muscle Tension Lines Group (MTLG) theory is applied to analyze and solve puzzles in the lesser-form cleft lip.This process itself also serves as a clinical practice test of the MTLG theory.%临床上由于对隐性唇裂的发生机制认识不足,在治疗方面倾向于采用唇裂的一般治疗思路进行“肌肉解剖复位”,修复效果常常与患者预期相距甚远.作者根据十余年来对唇隐裂的解剖学研究及临床观察,系统阐述了唇隐裂的肌肉错构特征,解释了唇隐裂令人困惑的临床表现.并进一步对隐性唇裂进行病理机制分型,提出唇隐裂的肌肉生物力学仿生修复技术——“尹氏唇鼻肌肉框架”,以指导临床手术治疗.该文初步总结了作者近年来对隐性唇裂的重新理解和认识,应用唇鼻肌肉张力带理论解析唇隐裂中诸多谜团,这个过程本身亦是对张力带理论的一次临床实践检验.