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편측성 이차구순비변형 환자의 반흔교정술 방법의 비교- 직선법과 회전신전법
Comparison of the Two Techniques for the Correction of Unilateral Secondary Cleft Lip Nasal Deformity: Straight Line Repair and Millard’s Rotation and Advancement Flap Technique

대한구순구개열학회지 2013년 16권 2호 p.9 ~ 15

송인석, 김희영, 이주환, 서병무,

소속 상세정보

송인석 ( Song In-Seok ) - 서울대학교 치의학대학원 구강악안면외과학교실
김희영 ( Kim Hui-Young ) - 서울대학교 치의학대학원 구강악안면외과학교실
이주환 ( Lee Ju-Hwan ) - 서울대학교 치의학대학원 구강악안면외과학교실
서병무 ( Seo Byoung-Moo ) - 서울대학교 치의학대학원 구강악안면외과학교실

KMID : 0952820130160020009

Abstract

For the correction of secondary cleft lip and nasal deformity, it is important to identify the reasons of deformation precisely. In this report, scar revision techniques, straight line repair and rotation-advancement flap, are described with appropriate cases for the correction of the unilateral secondary cleft lip nasal deformity. Additionally, these two techniques are presented with comparison of indications, functional outcomes and aesthetic results. A 15 year old boy who had a history of bilateral cleft lip repair was referred for the scar revision. Whistle lip deformity due to vertical scar contracture was found. However, nasal septum was not deviated and bilateral symmetry of the nostrils was preserved. Following excision of scar tissue, orbicularis oris muscle was rearranged functionally then separated lip was closed using straight line repair. The result was favorable and aesthetic reconstruction of the philtral ridge was possible postoperatively. However, excessive lip lengthening of the affected side was unsatisfactory, periodic follow-up is needed. A 34 year old man with cleft lip scar underwent scar contracture and skin depression as well as flattened nostril and deformed nasal ala. Following resection of the scar tissue according to the rotation-advancement flap technique, orbicularis oris musculature was rearranged. Each layer of mucosa, muscle, skin was sutured separately. The lip was lengthened sufficiently and symmetry of the nose was recovered postoperatively. Determination of the repair technique should be made by cause and extent of the deformity in secondary cleft lip nasal deformity. In this report, satisfactory revision of the scarred lip was possible using straight line repair or rotation-advancement flap technique as well as functional rearrangement of the orbicular oris muscle. The result was favorable aesthetically and functionally.