상하악에 동시 다발성 골신장술을 이용한 반안면왜소증의 치험례
Simultaneous Maxillo-Mandibular Distraction Osteogenesis in Hemifacial Microsomia: a Case Report
김일규, 박종원, 이언화, 양정은, 장재원, 편영훈, 왕붕,
소속 상세정보
김일규 ( Kim Ill-Kyu ) - 인하대학교 의과대학 치과학교실 구강악안면외과
박종원 ( Park Jong-Won ) - 인하대학교 의과대학 치과학교실 구강악안면외과
이언화 ( Lee Eon-Hwa ) - 인하대학교 의과대학 치과학교실 구강악안면외과
양정은 ( Yang Jung-Eun ) - 인하대학교 치과학교실 구강악안면외과
장재원 ( Chang Jae-Won ) - 인하대학교 치과학교실 구강악안면외과
편영훈 ( Pyun Young-Hoon ) - 인하대학교 의과대학 치과학교실 구강악안면외과
왕붕 ( Wang Boon ) - 인하대학교 치과학교실 구강악안면외과
KMID : 0360120100320050447
Abstract
The hemifacial microsomia is characterized by variable underdevelopment of the craniofacial skeleton, external ear, and facial soft tissues. So, patients with hemifacial microsomia have an occlusal plane canting and malocclusion with facial asymmetry. Distraction osteogenesis (DO) with an intraoral or extraoral device is a technique using tension to generate new bone with gradual bone movement and remodeling. DO has especially been used to correct craniofacial deformities such as a hemifacial microsomia, facial asymmetry, and mandible defect that could not adequately be treated by conventional reconstruction with osteotomies. It has a significant advantage to lengthen soft and hard tissue of underdeveloped site without bone graft and a few complication such as nerve injury or muscle contracture. A 13-years old girl visited our clinic for the chief complaint of facial asymmetry. She had a left hypoplastic maxilla and mandible, occlusal plane canting and malocclusion. We diagnosed hemifacial microsomia and planned DO to lengthen the affected side. Le Fort I osteotomy, left mandibular ramus and symphysis osteotomy were performed. The internal distraction devices fixed with screw on maxillary and mandibular ramus osteotomy sites. External devices were adapted to lower jaw for DO on symphysis osteotomy site and to upper jaw for rapid maxillary expansion (RME). At 7days after surgery, distraction was started at the rate of 1mm per day for 13days, and after 4months consolidation periods, distraction devices were removed. Simultaneous multiple maxillo-mandibular distraction osteogenesis with RME resulted in a satisfactory success in correcting facial asymmetry as well as occlusal plane canting for our hemifacial microsomia.
키워드
Hemifacial microsomia; Distraction osteogenesis; Maxilla and mandible; Osteotomy
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