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회전-신전법의 Mulliken 변형을 이용한 편측 구순열 수술
Repair of Unilateral Cleft Lip using Mulliken’s Modification of Rotation Advancement

대한구순구개열학회지 2012년 15권 1호 p.21 ~ 28

이규태, 임재석, 정휘동, 정영수,

소속 상세정보

이규태 ( Lee Gyu-Tae ) - 연세대학교 치과대학 구강악안면외과학교실
임재석 ( Lim Jae-Seok ) - 연세대학교 치과대학 구강악안면외과학교실
정휘동 ( Jung Hwui-Dong ) - 연세대학교 치과대학 구강악안면외과학교실
정영수 ( Jung Young-Soo ) - 연세대학교 치과대학 구강악안면외과학교실

KMID : 0952820120150010021

Abstract

Unilateral cleft lip is not a simple and independent problem in all aspects. nasal deformity results from the cleft lip, maxillary hypoplasia, and abnormal muscular pull on the nasal structures, including abnormal muscular tension on the alar base and abnormal position of the orbicularis oris muscle. Its gross and histopathologic characteristics include widening of the alar base, a midline deviation of the columella and septum to the noncleft side, dorsal displacement of the dome, lateral rotation of medial crura, buckling of the alar cartilage, and underdevelopment of the pyriform aperture. Since Dr. Millard first presented his method for repair of the unilateral cleft lip and nasal deformity in 1955, no other technique has gained as much popularity as the rotation-advancement principle. Principles established more than 50 years ago and techniques are evolving continuously. Unlike earlier procedures, this repair gives the surgeon the opportunity to manipulate the individual cleft elements through various modifications while maintaining Millard’s original surgical and anatomical goals. Although this strategy is applied worldwide, successful execution is variable and highly operator dependent. Millard and many other surgeons have made technical variations to adjust the procedure to each specific patient, to address some of its faults, and to gain new advantages. We will review the Mulliken’s modifications that Dr. Millard made to his original rotation-advancement principle and inform cases applied modifying the rotation-advancement principle.