近20年来, 国内外均有学者强调鼻翼软骨环的解剖概念, 鼻翼软骨环的基本定义为嵌插于前鼻棘上的鼻中隔、鼻翼软骨的内脚、鼻翼软骨内脚到外脚的连续、小翼软骨链以及鼻孔基底的纤维组织共同围城的环状结构。国内郑永生等通过唇裂试题解剖进一步提出, 由于鼻肌的参与, 该结构实质为鼻翼软骨肌肉环, 而在唇裂患者, 裂侧鼻翼软骨纤维环在鼻孔基底遭到破坏, 裂侧鼻肌的小柱部缺如, 而鼻肌翼部和横部蜷缩于裂开的上颌骨缘外, 表明鼻翼软骨肌肉环也遭破坏。应用健侧口轮匝肌鼻底肌肉瓣C, 与离断的患侧鼻肌翼部肌肉瓣D分别向对侧推进, 交叉缝合于对侧的鼻底和鼻小柱基底的肌肉异位止点残端, 形成“鼻孔基地肌肉半环结构”, 可在恢复鼻底丰满度的同时内收鼻翼, 矫正鼻小柱位置, 有利于鼻翼拱形的形成和鼻孔形态的矫正北京日语翻译。本步骤要求肌肉解剖准确, 缝合时肌肉环形成确切, 如此对避免鼻畸形的发展有利。

Over the past 20 years, domestic and foreign scholars have stressed the anatomical concept of alar cartilage ring. The basic definition of alar cartilage ring refers to a ring structure which is composed of fibrous tissues that inserting into nasal septum of spina nasalis anterior, inner foot of alar cartilage, connective part between the inner and outer foot of alar cartilage, accessory quadrate cartilage chain and nasal base. Based on anatomical experiments of cleft lip, Zheng Yongsheng et al, Chinese researchers, further suggested that it belongs to an alar cartilage muscle ring because of the participation of nasal muscle; but for those patients with cleft lip, affected alar cartilage fibrous ring at the nasal base is damaged and nasal columella of affected nasal muscle is defected. While alar and transverse parts of nasal muscle crouch outside the edge of chapped maxilla, which indicates damaged alar cartilage muscle ring. Crossly stretching unaffected orbicularis oris muscle flap C and affected alar muscle flap D, then suturing crossly them on the contralateral muscle stumps with abnormal endpoints of nasal base and nasal columella base respectively so as to form “nasal base muscle semi-ring structure”. In addition to restore the fullness of nasal base, this suture method can also adduct nosewing and correct the position of nasal columella and thus be beneficial for the formation of vaulted nosewing as well as the correction of shape of nostril. Accurate muscular anatomy and definitely forming muscle ring while suture are necessary for the step above, which will be beneficial to avoid nasal abnormality.

关于人中嵴的成形。本组30例忠者应用“鼻孔周缘肌肉环”设计缝合后, 可见上唇口轮匝肌瓣的主体部分在人中嵴区域堆积。此时可行肌肉瓣的过度外翻缝合或瓦合缝合, 形成人中嵴隆起。我们的经验是过度外翻缝合在形成人中嵴的同时常会造成较明显的人中窝, 形态更为自然上海英语翻译。

Formation of philtrum ridge. After treating 30 patients in the group with “nostril peripheral muscle ring" suture, accumulated main part of orbicularis oris muscle flap of upper lip could be observed at the philtrum ridge. Subsequently, excessive everting suture or watt co-suture can be adopted to suture muscle flaps so as to form philtrum ridge. We found that, except for forming philtrum ridge, excessive everting suture can also form obvious philtrum fossa and thus a natural shape can be obtained.