선천성 및 외상성 내안각변형에서 시행한 여러 가지 내안각성형술의 비교, 분석

Abstract

Medial canthoplasty is required to correct congenital anomaly and acquired deformity after trauma, especially nasoethmoid orbital fracture and to correct epicanthal fold. Several medial canthal surgical procedures have been used, but the postoperative results have not always been estimated. Between January 1, 1986 and April 30, 2000, 55 medial canthoplasties were performed in 32 patients. We report the experiences with 55 medial canthoplasties and analyze and compare each methods. The patients who underwent medial canthoplasty were analyzed anthropometrically by the ratio of left to right palpebral fissure dimension, the ratio of postoperative to preoperative palpebral fissure dimension and the ratio of postoperative to preoperative intercanthal distance. And every patient was analyzed clinically by ordinary scale method. Of several singly performed medial canthoplasties, del Campo technique was excellent because the ratio was much improved anthropometrically and the clinical assessments were 'excellent'. Of several singly performed medial canthopexies, transnasal wiring was excellent anthropometrically and clinically. Of simultaneously performed medial canthoplasties, del Campo technique with transnasal wiring were excellent because the ratio was much improved anthropometrically and the clinical assessments were 'excellent'. And the results of simultaneously performed medial canthoplasties group was better than that of singly performed medial canthoplasties group. And so, we concluded that del Campo technique with transnasal wiring for severe cases were recommendable for medial canthoplasty.

저자들은 내안각의 변형을 가진 32명의 환자를 대상으로 여러 가지 내안각성형술과 내안각고정술을 실시하였다. 인체계측법과 임상적 평가에서 단독으로 실시한 여러 가지 내안각성형술 가운데에서는 del Campo법이, 단독으로 실시한 여러 가지 내안각고정술에서는 경비내안각철사고정술이 가장 좋은 결과를 보였다. 내안각성형술과 내안각고정술을 동시에 실시한 례 가운데에서는 del Campo법과 경비내안각철사고정술을 실시한 례가 가장 좋은 결과를 보였다. 또한 내안각성형술과 내안각고정술을 동시에 실시한 례가 단독으로 1가지만을 실시한 례보다 더 좋은 결과를 보였다. 따라서 심한 선천성 기형이나 비-사골-안와골골절에 의한 내안각변형과 같은 경우에는 피부의 과다나 잘못된 분배를 해결할 수 있는 내안각성형술과 내안각건과 연조직의 문제점을 해결할 수 있는 내안각고정술의 장점을 잘 살려, 2가지를 동시에 실시하는 것이 가장 바람직하다고 하겠다.