PDF(Pubmed)
Abstract：
UNASSIGNED: Macrostomia is a congenital deformity found in Tessier no. 7 facial clefts defined as an enlargement of the mouth at the oral commissure. Several techniques are described in literature to achieve optimal functional and aesthetic results, with varying results and surgeon preferences. In this case series we report surgical repair of macrostomia with a vermillion square flap method for the oral commissure combined with either Z-plasty or W-plasty closure for the skin.
METHODS: A retrospective case analysis of 12 patients with macrostomia operated over the past 7 years at our plastic surgery division was performed (by two different operators; 11 cases by A.S. and 1 case by R.S.). Clinical features of the patients were analyzed through photography documentation, and patient description such as age of operation, operation technique, and complications were obtained through patient records. Macrostomia was corrected with a vermillion square flap method for commissure, overlapping muscle closure, along with either Z-plasty or W-plasty closure for the skin. Quality of lip commissure position, symmetry, thickness of vermillion, and scar result were recorded.
UNASSIGNED: In all twelve patients repaired with the overlapping muscle closure and square flap, the lip commissures were formed with satisfactory shape, position, and thickness with no commissure contracture during the follow up period. The Z-plasty was a simpler method compared to the W-plasty, and resulted in comparable scars. One patient (adult with hemifacial macrostomia and W-plasty skin closure) underwent revision surgery for more accurate symmetry and position of the oral commissure.
CONCLUSIONS: There are many varieties of surgical repair for macrostomia, and each method should be adjusted and combined according to each patient. Overall, macrostomia repair with this technique combination produced satisfactory aesthetic and functional results in all twelve patients. Z-plasty for skin closure after muscle and vermillion closure was a simpler technique and resulted in comparable scars than W-pasty closure in this case series.
METHODS: A retrospective case analysis of 12 patients with macrostomia operated over the past 7 years at our plastic surgery division was performed (by two different operators; 11 cases by A.S. and 1 case by R.S.). Clinical features of the patients were analyzed through photography documentation, and patient description such as age of operation, operation technique, and complications were obtained through patient records. Macrostomia was corrected with a vermillion square flap method for commissure, overlapping muscle closure, along with either Z-plasty or W-plasty closure for the skin. Quality of lip commissure position, symmetry, thickness of vermillion, and scar result were recorded.
UNASSIGNED: In all twelve patients repaired with the overlapping muscle closure and square flap, the lip commissures were formed with satisfactory shape, position, and thickness with no commissure contracture during the follow up period. The Z-plasty was a simpler method compared to the W-plasty, and resulted in comparable scars. One patient (adult with hemifacial macrostomia and W-plasty skin closure) underwent revision surgery for more accurate symmetry and position of the oral commissure.
CONCLUSIONS: There are many varieties of surgical repair for macrostomia, and each method should be adjusted and combined according to each patient. Overall, macrostomia repair with this technique combination produced satisfactory aesthetic and functional results in all twelve patients. Z-plasty for skin closure after muscle and vermillion closure was a simpler technique and resulted in comparable scars than W-pasty closure in this case series.
摘要：
■大口畸形是在Tessier号发现的先天性畸形。7个面部裂隙被定义为口腔连合处的口腔扩大。文献中描述了几种技术，以实现最佳的功能和美学效果，不同的结果和外科医生的偏好。在此病例系列中，我们报告了使用真方皮瓣方法进行口腔连合并结合Z成形术或W成形术闭合皮肤的手术修复。
方法：对过去7年在我们整形外科手术的12例巨大口症患者进行了回顾性病例分析（两名不同的手术者；A.S.11例，R.S.1例）。通过摄影文档分析患者的临床特征，和病人描述，如手术年龄，操作技术,并通过患者记录获得并发症。用朱砂平方皮瓣法矫正大口口，重叠的肌肉闭合，连同Z-成形术或W-成形术闭合皮肤。唇合缝位置的质量，对称性，朱红色的厚度，记录瘢痕结果。
■在所有12例用重叠肌肉闭合和方形皮瓣修复的患者中，嘴唇连合形成了令人满意的形状，position,随访期间无连合挛缩的厚度。与W型成形术相比，Z型成形术是一种更简单的方法，并导致类似的伤疤。一名患者（患有半面部大型造口症和W形皮肤闭合的成人）接受了翻修手术，以更准确地对称和位置口腔连合。
结论：巨口的外科修复有许多种类，每种方法应根据每个患者进行调整和组合。总的来说,使用该技术组合进行的大型口腔修复在所有12例患者中产生了令人满意的美学和功能结果。在这种情况下，肌肉和朱红色闭合后用于皮肤闭合的Z-成形术是一种更简单的技术，与W-pasty闭合相比，会产生类似的疤痕。
方法：对过去7年在我们整形外科手术的12例巨大口症患者进行了回顾性病例分析（两名不同的手术者；A.S.11例，R.S.1例）。通过摄影文档分析患者的临床特征，和病人描述，如手术年龄，操作技术,并通过患者记录获得并发症。用朱砂平方皮瓣法矫正大口口，重叠的肌肉闭合，连同Z-成形术或W-成形术闭合皮肤。唇合缝位置的质量，对称性，朱红色的厚度，记录瘢痕结果。
■在所有12例用重叠肌肉闭合和方形皮瓣修复的患者中，嘴唇连合形成了令人满意的形状，position,随访期间无连合挛缩的厚度。与W型成形术相比，Z型成形术是一种更简单的方法，并导致类似的伤疤。一名患者（患有半面部大型造口症和W形皮肤闭合的成人）接受了翻修手术，以更准确地对称和位置口腔连合。
结论：巨口的外科修复有许多种类，每种方法应根据每个患者进行调整和组合。总的来说,使用该技术组合进行的大型口腔修复在所有12例患者中产生了令人满意的美学和功能结果。在这种情况下，肌肉和朱红色闭合后用于皮肤闭合的Z-成形术是一种更简单的技术，与W-pasty闭合相比，会产生类似的疤痕。
