구순열 코변형의 외과적 교정술에 대한 임상적 연구
Clincal Study on Surgical Correction of Cleft Nasal Deformi
이영기, 박영욱,
소속 상세정보
이영기 ( Lee Young-Kee ) - 강릉원주대학교 치과대학 구강악안면외과학교실
박영욱 ( Park Young-Wook ) - 강릉원주대학교 치과대학 구강악안면외과학교실
Abstract
Introduction: The nasal deformity exists congenitally in patients with cleft in primary palate, which evolves by the effect of surgeries and growth changes. Therefore, a longitudinal care of cleft nasal deformity is rewarded with progressive improvements and predictable results. We investigated cleft rhinoplasty with regard to patients’ age and operation modality. Materials and Methods: The subjects included 46 patients who were diagnosed as secondary cleft nasal deformity. Medical records and peri-operative clinical photographs were analyzed retrospectively. Results: 37 patients showed unilateral cleft nasal deformity and 9 patients demonstrated bilateral cleft nasal deformity. Main nasal deformities in unilateral cleft were nasal asymmetry, displaced nasal tip to the normal side, columellar deviation, downed alar base and widened nostil base on cleft side. Main nasal deformities in bilateral cleft were flat nose, short columella, obtuse angle between medial and lateral crus of the lower lateral cartilage, also downed alar base and widened nostril base. 48 cleft rhinoplasties were performed. Mean age of the patients was 16 years and 9 months. Limited rhinoplasty via intranasal incision was performed under 10 years of patient’s age. For above 10 years of age, open rhinoplasty was performed with various graft procedures. Limiting factors for successful cleft rhinoplasty were underdeveloped skeletal base, scar burden, or iatrogenic deformity during antecedent surgeries. Conclusion: To minimize cleft nasal deformities, symmetry of the nostril for unilateral cleft and columellar lengthening for bilateral cleft should be achieved during primary cheiloplasty. And sound skeletal base of the nose is a prerequisite for successful cleft rhinoplasty.
키워드
Cleft lip nasal deformity; Iatrogenic injury; Secondary cleft nasal deformity; Limited rhinoplasty; Definitive rhinoplasty
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