| Background Cleft lip is more common congenital facial malformations, pathogenesis unclear, an(initial) within six months of repair often carried out with the patient’s growth and development, and its lip nasal deformities gradually, most patients two need repair. Its secondary deformity presents diversity, structural lesion presents certain degree of particularity, its main purpose is to repair and restore the appearance of functional trimming. Preoperative can accurately recognize abnormal muscle and skeletal malformations degree cleft lip patient, precise, perfect repair is a permanent topic of plastic surgery, for which we conducted a series of studies in the early stage of research, the application of 64-slice spiral CT three-dimensional reconstruction of the normal pear-shaped hole area normal bone and unilateral cleft lip patients piriform aperture area skeletal anomalies in-depth discussions, it has obtained good results and clinical significance of cleft lip and palate corrective surgery. Skeletal muscle repair and restoration should be equally important in obtaining a 64-slice spiral CT bone after treatment of cleft lip deformity good results, we need an effective way to detect normal human lip and nose area muscle anatomy and cleft lip patients lip and nose area muscle anatomy, to gauge the degree of deformity in patients with cleft lip and personality differences, and to thereby guide us to develop individualized treatment plan surgical repair, while our postoperative treatment effect relative evaluation. Understanding normal human lip and nose area muscle anatomy is the foundation of cleft lip repair surgery, this experiment through clinical observation of unilateral cleft lip nasal deformities lip 20 patients, gross appearance of the state and intraoperative findings in a comprehensive analysis of the state of the muscle tissue; at the same time on two substantially wet specimens dissection, MRI of 10 cases of normal human lip and nose area of muscle and soft tissue imaging to explore the concept of a state under a substantially unilateral cleft lip nasal deformity secondary characteristics and classification, normal human muscle lip and nose area anatomical characteristics, as well as MRI in the human nose and lip area muscle anatomy depict the accuracy and feasibility. And the MRI detection of unilateral cleft lip nasal labial lip and nose study area characterized by abnormal muscle anatomy to provide evidence.Objective 1.Under the proposed concept of a state generally unilateral cleft lip nasal deformities lip characteristics and are broadly classified; 2.Understanding normal human lip and nose area muscle anatomy and comprehensive testing method from the perspective of cleft lip repair; 3.Discussion MRI detection of human muscle and soft tissue lip and nose area of accuracy, feasibility and practical significance.Methods 1.Adopted in September 2014 until September 2015, the First Affiliated Hospital of Zhengzhou University Plastic Surgery admitted "unilateral cleft lip nasal deformities secondary to" 20 patients were observed collected lip nasal deformities of unilateral cleft lip patient’s appearance changed circumstances, and exploratory surgery in patients with lip and nose area of the state of the muscles, unilateral cleft lip nasal deformities secondary to the patient’s deformity statistics and classification; 2.For two(1 man and 1 woman) generally to wet specimens(provided by the anatomy of the basic medical college of Zhengzhou university teaching and research section) layered dissection muffle, observe specimens of normal human body lip nasal area muscle load-point, arrangement, direction, level and intersection, etc.; 3.Collected in the first affiliated hospital of Zhengzhou university line of maxillofacial soft tissue disease in patients with 10 cases of cranial MRI image information, and other methods, using the data obtained directly or indirectly to the patient’s data were retrospectively analyzing, observe MRI scan and reconstruction cases, normal lip nasal muscle load-point, arrangement, and hierarchy, etc.; 4.Combined with gross observation and in the collection of cleft lip patients related head MRI results, comprehensive analysis of lip nasal muscle anatomical features, observe MRI depicted lip nasal area muscle on the accuracy of the anatomical features.Results 1.Organizational change can be seen according to nose lip morphology changes and surgery, the secondary unilateral cleft lip nasal deformities divided into three categories: Mild: That is a kind, mild nasal morphology changes or none of which nostril width and height bilateral differences <2.0mm, intraoperative findings organizational change lighter; lip morphology changes were mild or no, surgery tissue changes seen in light; Moderate: II and III include: II, nasal morphology change significantly, which nostril width and height bilateral differences> 2.0mm, intraoperative findings organization change significantly; lip morphology changes were mild or absent, intraoperative findings organizational change less; III, nasal morphology changes were mild or absent, in which the nose width and height bilateral differences <2.0mm, intraoperative findings organizational change lighter; lip morphology changed significantly intraoperative findings organization change significantly; Severe: nasal morphology change significantly, which nostril width and height bilateral differences> 2.0mm, intraoperative findings organization change significantly; and lip morphology changed significantly intraoperative findings organization change significantly. 2.MRI imaging examination of maxillofacial soft tissue disease the lip nasal muscle load-point, arrangement, direction, level and intersection, and gross income consistent; 3.Around the lip muscle group including lip, lip and orbicularisoris muscles groups;Superior and the zygomatic major muscle groups including smile, zygomatic small muscle, spat nose upper lip muscles and the muscle and upper lip muscle;Group of lower lip muscles, including reduction under the quarrel and chin muscles;Orbicularisoris muscles are arranged ring, the muscle fiber is located in the upper and lower lips, shallow layer is composed of natural fiber, by upper and lower lip muscles around the middle, two groups of muscle fibers woven deep by the buccinator and lips around part of the muscle fibers; 4.Nasal muscle mainly includes the nasal root flesh, depressor septi muscles and muscle.Depressor septi muscles and nasal muscle to close or open the main function of big nostrils;Nasal root muscle can pull the brow skin make it down, and make the nose root skin shrivel and produce horizontal stripes; 5.Orbicularisoris muscles located in the deep muscles except with horizontal surround muscle fibers, and go along the quarrel in the oblique line fan of muscle fibers, part of the muscle fibers across the midline, migration from the bottom of the nose to nose nasal muscle, the upper lip near the red lip edge transitions for zygomatic upper lip levator muscle and small, and under the nose transitional levator muscle of upper lip nose;Another part of the check before the columella under nasal crest, migration of nasal septum depressor.Alar nasal muscle end connected to the alar cartilage of the lateral Angle, at the other end are transitional orbicularisoris muscles;Nasal septum depressor end connected to the alar cartilage, medial Angle, at the other end are transitional orbicularisoris muscles.Small zygomatic upper lip levator muscle and lateral edge to the center line from the nose and the last in orbicularisoris muscles deep intersection near the red lip side eversion, and is of important significance to the formation of the lip bow.Conclusions 1. According to the lip nasal morphology changes and intraoperative findings tissue changes may be unilateral cleft lip nasal deformities secondary degree is divided into three four categories; 2. MRI depicting the human anatomy muscles lip and nose area having the accuracy and feasibility; 3.MRI and gross anatomy specimens moist lip and nose area of the normal anatomy of the muscle helps to describe the integrated implementation of cleft lip repair surgery. |
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