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Abstract：
BACKGROUND: Several variations on the surgical technique for macrostomia repair have been described in the literature. There has been controversy regarding the preferred method for commissuroplasty and skin closure for optimal functional and aesthetic results. The aim of this study is to present these techniques and the most described methods up to date.Further, five patients operated with a combination of techniques are presented.
METHODS: PRISMA guidelines were followed for literature review.Five consecutive patients with unilateral macrostomia operated during a period of one and a half years at our craniofacial department were included in this study.
RESULTS: 31 studies on macrostomia repair were obtained. The layered closure technique is widely described with several variations on closure of the inner mucosa, orbicularis muscle, commissure and skin. The inner mucosal layer is in most cases sutured with a straight line closure technique. The muscle is most often duplicated and sutured with upper branches overlapping lower branches. The skin is in most cases sutured with either a z- or a w-plasty with variations.The five presented patients all had satisfactory functional and aesthetic results at follow-up.
CONCLUSIONS: Many variations of surgical techniques for macrostomia repair have been presented in the past. We believe that each case of macrostomia needs to be assessed with a tailored surgical plan in order to create the best results. A combination of different techniques with Bütow and Botha\'s and Kaplan\'s technique as a starting point, is believed to give satisfactory functional and aesthetic results.
METHODS: PRISMA guidelines were followed for literature review.Five consecutive patients with unilateral macrostomia operated during a period of one and a half years at our craniofacial department were included in this study.
RESULTS: 31 studies on macrostomia repair were obtained. The layered closure technique is widely described with several variations on closure of the inner mucosa, orbicularis muscle, commissure and skin. The inner mucosal layer is in most cases sutured with a straight line closure technique. The muscle is most often duplicated and sutured with upper branches overlapping lower branches. The skin is in most cases sutured with either a z- or a w-plasty with variations.The five presented patients all had satisfactory functional and aesthetic results at follow-up.
CONCLUSIONS: Many variations of surgical techniques for macrostomia repair have been presented in the past. We believe that each case of macrostomia needs to be assessed with a tailored surgical plan in order to create the best results. A combination of different techniques with Bütow and Botha\'s and Kaplan\'s technique as a starting point, is believed to give satisfactory functional and aesthetic results.
摘要：
背景：文献中已经描述了用于大口修复的外科技术的几种变体。关于理想的功能和美学效果的连缝成形术和皮肤闭合的首选方法一直存在争议。这项研究的目的是介绍这些技术和最新的描述方法。Further,介绍了五名采用组合技术进行手术的患者。
方法：遵循PRISMA指南进行文献综述。这项研究包括在我们的颅面部门进行了一年半的连续5例单侧巨大口症患者。
结果：获得了31项关于大口修复的研究。分层闭合技术被广泛描述为内部粘膜闭合的几种变体，眼轮匝肌，连缝和皮肤。在大多数情况下，内粘膜层采用直线闭合技术缝合。肌肉最常被复制和缝合，上部分支重叠下部分支。在大多数情况下,皮肤用具有变化的z-或w-成形术缝合。5名患者在随访中均获得了满意的功能和美学效果。
结论：过去已经提出了许多用于大口修复的外科技术的变体。我们认为，每例巨大口症都需要通过量身定制的手术计划进行评估，以创造最佳效果。以Bütow和Botha\和Kaplan\的技术为起点，结合了不同的技术，被认为能提供令人满意的功能和美学效果。
方法：遵循PRISMA指南进行文献综述。这项研究包括在我们的颅面部门进行了一年半的连续5例单侧巨大口症患者。
结果：获得了31项关于大口修复的研究。分层闭合技术被广泛描述为内部粘膜闭合的几种变体，眼轮匝肌，连缝和皮肤。在大多数情况下，内粘膜层采用直线闭合技术缝合。肌肉最常被复制和缝合，上部分支重叠下部分支。在大多数情况下,皮肤用具有变化的z-或w-成形术缝合。5名患者在随访中均获得了满意的功能和美学效果。
结论：过去已经提出了许多用于大口修复的外科技术的变体。我们认为，每例巨大口症都需要通过量身定制的手术计划进行评估，以创造最佳效果。以Bütow和Botha\和Kaplan\的技术为起点，结合了不同的技术，被认为能提供令人满意的功能和美学效果。
