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일측성 구순열비변형에서 다공성 폴리에틸렌 판을 이용한 상악골이상구증대술

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Author(s)
한기환김진한최태현김준형손대구Ki Hwan HanJin Han KimTae Hyun ChoiJun Hyung KimDae Gu Son
Keimyung Author(s)
Son, Dae GuKim, Jun HyungHan, Ki HwanChoi, Tae Hyun
Department
Dept. of Plastic Surgery (성형외과학)
Journal Title
대한성형외과학회지
Issued Date
2008
Volume
35
Issue
4
Abstract
PURPOSE: The common deformity after the correction of unilateral cleft lip nasal deformity is nasal asymmetry, and it is caused by the hypoplasia of the pyriform aperture. To correct this, many procedures have been applied, but still many problems are present. Authors performed the inlay and onlay insertion of porous high density polyethylene sheet(1mm thickness Medpor(R) sheet) in the hypoplastic pyriform margin of cleft side and obtained satisfactory results. METHODS: 11 cases were performed and the mean follow up period was 15.1 months. Their mean age was 23.6 years. Under general anesthesia, bilateral pyriform margin was exposed. Medpor(R) sheets in "match stick" like shaped were inlay inserted, and kidney shaped were onlay inserted fixating with two 6mm titanium screws. After the surgery, the results was evaluated by photogrammetric analysis. On the basal view, the distance from the subalare and labiale superius' to the transverse baseline connecting the both cheilions was measured from the cleft side and the non-cleft side. Then, the postoperative symmetry was assessed by obtaining the cleft side against the non-cleft side as proportion index, defined as lateral and medial upper lip contour index. RESULTS: There were 2 infections. The cause was because the inserted implant was too long and thus protruded to the base of nasal cavity. The lateral upper lip contour index was from 95.49 to 103.27, and medial upper lip contour index was from 90.92 to 100.49, it was statistically increased, and thus the symmetry was improved. However clinically mild depression remained at nostril floor. CONCLUSION: Authors performed porous high density polyethylene sheet inlay and onlay insertion for the hypoplasia of the pyriform margin in unilateral cleft lip nasal deformity. It was found that depressed pyriform margin and upper lip were corrected effectively except for the nostril floor, for which an additional soft tissue augmentation would be necessary. The inlay insertion has risk of protrusion, thus the guideline of the use of artificial prosthesis should be observed strictly.
Alternative Title
Augmentation of Pyriform Margin Using Porous High-Density Polyethylene Sheet In Unilateral Cleft Lip Nasal Deformity
Keimyung Author(s)(Kor)
한기환
최태현
김준형
손대구
Publisher
School of Medicine
Citation
한기환 et al. (2008). 일측성 구순열비변형에서 다공성 폴리에틸렌 판을 이용한 상악골이상구증대술. 대한성형외과학회지, 35(4), 431–438.
Type
Article
ISSN
1015-6402
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/39313
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Plastic Surgery (성형외과학)
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